Elementary School Application Form

Enroll new students with everything the school needs on file: child details, parent contacts, allergies, special needs, and authorized pickups. Built for elementary schools and after-school programs.

Use this template

Child's name

Nombre

Apellido

Child's date of birth

Address

Dirección

Ciudad

Estado / Provincia

Código postal

Child's school name

Child's teacher's name

Nombre

Apellido

Child's grade

Mother's or guardian's name

Nombre

Apellido

Mother's or guardian's cell phone

Mother's or guardian's email

Father's or guardian's name

Nombre

Apellido

Father's or guardian's cell phone

Father's or guardian's email

Family's church

Is a parent in the military?

Are there any custody or safety concerns for this child?

If you answered "yes", share the custody or safety details so we can keep your child safe.

Does the child have any special needs (ADD, Asperger's, dyslexia, etc.)?

If you answered "yes", list the child's special needs.

Does your child have any allergies (peanuts, chocolate, etc.)?

If you answered "yes", list your child's allergies.

Emergency contact #1

Nombre

Apellido

Phone number

Emergency contact #2

Nombre

Apellido

Phone number

Besides those listed above, note who else may pick your child up from school.

List anyone who is NOT allowed to pick your child up.

After club, my child will get home by:

Picked up by a parent or guardian Picked up by an authorized adult Walks home School bus

Name

Nombre

Apellido

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