Pond Creek-Hunter Elementary School Online Enrollment Packet
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General Information
Child First Name *
Child Middle Name
Child Last Name *
SSN
Date of Birth *
(MM/DD/YYYY)
Birthplace City State *
Mailing Address *
Home Street Address *
City State Zip *
Gender *
Ethnic Group *
US Citizen *
Last School Attended *
Grade Entering *
Is a language other than English used in the home? *
If Yes, what is that language
If Yes, is that other language spoken in the home
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Student resides with *
Are there Legal/Custody Papers pertaining to this child?  Please note, the school must have a copy of the court order on file declaring custody arrangement. *
Guardian 1 First Name
Guardian 1 Last Name
Guardian 1 Home Phone Number
Guardian 1 Cell Phone Number
Guardian 1 Mailing Address
Guardian 1 City, State, Zip Code
Guardian 1 E-Mail Address
Guardian 1 Place Of Employment
Guardian 1 Work Phone Number
Guardian 2 First Name
Guardian 2 Last Name
Guardian 2 Home Phone Number
Guardian 2 Cell Phone Number
Guardian 2 Mailing Address
Guardian 2 City, State, Zip
Guardian 2 E-Mail Address
Guardian 2 Place Of Employment
Guardian 2 Work Phone Number
Emergency Contact First Name *
Emergency Contact Last Name *
Emergency Contact Phone Number *
Emergency Contact Relationship To Child *
Please list any important medical information and/or food allergies for student:
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