WAGGONER CREEK ELEMENTARY SCHOOL ENROLLMENT INSTRUCTIONS

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1 WAGGONER CREEK ELEMENTARY SCHOOL ENROLLMENT INSTRUCTIONS Dear Parent/Guardian: We are excited that you have chosen Waggoner Creek Elementary School for your student. The following records are needed to complete the enrollment process. Please let us know if we can help you in any way with the enrollment process. DOCUMENTS REQUIRED FOR ENROLLMENT (Current TISD Student): Transfer Form Proof of Residence Please provide a current utility bill, lease agreement or tax statement verifying parent/guardian s residence. DOCUMENTS REQUIRED FOR ENROLLMENT (Students new to TISD): TISD Student Enrollment Form Home Language Survey Parental Consent for Release of Student Records Transfer Form or Statement of Services Proof of Residence Please provide a current utility bill, lease agreement or tax statement verifying parent/guardian s residence. Copy of Birth Certificate Copy of Social Security Card Immunization Record Texas Department of Health regulations require immunization records be provided prior to enrollment. AFTER-SCHOOL CARE Tiger Learning Center offers after-school care to students attending Waggoner Creek Elementary. A limited number of students can be accommodated so a wait list is maintained. Please contact for more information. TRANSPORTATION Bus transportation is only available for students who live in the Waggoner Creek attendance zone. All transfer students must provide their own transportation to and from school. RETURN ALL RECORDS TO: Texarkana ISD Attn: Nanette Power 4241 Summerhill Road Texarkana, Texas For questions or assistance, please call ext or 1032 or

2 Student Enrollment Form School Waggoner Creek Elementary School Student I.D. Today s Date Grade STUDENT INFORMATION Name: First Middle Last Gen Student s name exactly as shown on Birth Certificate Jr. / Sr. / II / III / IV / V Birth Date - - Place of Birth (City, State) Sex Male Female Texas Public School Ethnicity and Race Data Elementary nearest your residence Ethnicity(Circle one) Race(Circle one or more) Circle one Hispanic/Latino Not Hispanic/Latino American Indian or Alaska Native Asian Black or African American Native Hawaiian or Other Pacific Islander White 115 Dunbar/Theron Jones 105 Highland Park 109 Nash 111 Spring Lake Park 113 Wake Village 108 Westlawn 117 Waggoner Creek 019 Texas - Out of District 255 Out of State TISD Resident Yes No If No, District of Residence Social Security Number - - All out of district residents must complete a transfer application. Has student ever attended a Texarkana ISD school? Yes No School Grade Previous School City State Grade Year Previous School City State Grade Year Previous School City State Grade Year ENROLLING PARENT INFORMATION Mother Step-Mother Guardian Name Birth Date May we contact you with text messages? Father Step-Father Guardian Name Birth Date May we contact you with text messages? With whom does the student live? Both Parents Mother Father Grandparent Other Additional parent contact information may be added on the inside page. Tiger 411 is a mass communication system used to deliver important announcements such as inclement weather alerts and school closure information. The enrolling parent s home phone number, address, and, possibly, the cell phone will be used to receive these important announcements. TISD 03/18/2016

3 ADDITIONAL PARENT INFORMATION Mother Step-Mother Guardian Name Birth Date Father Step-Father Guardian Name Birth Date EMERGENCY CONTACT INFORMATION Other than parent or guardian Name Relationship to Student Home Phone Work Phone Cell Phone Name Relationship to Student Home Phone Work Phone Cell Phone BROTHERS/SISTERS ATTENDING TISD Name ID School Name ID School Name ID School TRANSPORTATION Will your child need to ride a bus? Yes No (Transportation provided only if student meets eligibility requirements.) ENROLLING PARENT SIGNATURE Texarkana ISD is required to inform persons enrolling a student in this District that: Presenting false information or false records for identification is a criminal offense under Penal Code and that enrolling a child under false documents makes that person liable for tuition or other costs as provided below. Education Code (d). A person who knowingly falsifies information on a form required for a student s enrollment in the District is liable to the District if the student is not eligible for enrollment, but is enrolled on the basis of false information. For the period, during which the ineligible student is enrolled, the person is liable for the maximum tuition fee the District may charge or the amount the District has budgeted per student as maintenance and operation expense, whichever is greater. Education Code (h). Signature of Enrolling Parent/Guardian Enrolling Parent/Guardian Driver s License Number Signature of Enrolling Student Date State Date TISD 03/18/2016

4 home language survey TO BE COMPLETED BY PARENT OR GUARDIAN (OR STUDENT IF GRADES 9-12): The state of Texas requires that the following information be completed for each student that enrolls for the first time in Texas public schools. This survey shall be kept in each student s permanent record folder. (19TAC Chapter 89, Subchapter BB ) NAME OF STUDENT: 1. What language is spoken in your home most of the time? 2. What language does your child (do you) speak most of the time? 3. What language is your preference for all TISD mailings/phone calls? Signature of Parent/Guardian: Date: Signature of Student if Grades 9-12: Date:

5 Waggoner Creek Elementary School Parental Consent for Release of Student Records By my signature, I grant permission for the release of the following student records for, whom I certify to be my child or legal ward. Birth Date Social Security No. Grade Name of previous school attended Address of previous school attended Records to be release: 1. Cumulative File (Please include Special Education information, Speech, Gifted and Talented, 504 and any other special services information.) 2. Health and Immunization Records 3. Test Scores 4. PEIMS Information (if Texas Public School) 5. Copy of Birth Certificate, Social Security Card and all Report Cards 6. Has student ever been retained? If so, for what grade(s)? The records listed above are to be released to: Texarkana Independent School District Fax #: Summerhill Road Phone: Texarkana, Texas ext According to the Final Regulations Family Educational Rights and Privacy Act (Buckley Amendment), dated June 17, 1976, it is no longer necessary to obtain written consent to release records. It states that school officials, including teachers within the education institution, and officials of other school systems in which the student may intend to enroll, may receive a student s record without a written consent for such release. Parent Signature: Date Records Requested:

6 Waggoner Creek Elementary School Statement of Services Form Student s Name: Grade: In order to adequately serve your child, it is necessary to request the following information to determine if special services will be needed. Please circle the appropriate response. Yes No Is English spoken in your home most of the time? If no, what language is spoken? Yes No Have you ever suspected that your child might have a learning disability? If yes, has your child ever been referred for a comprehensive assessment? If yes, please give referral date and who did the evaluation. Date: Evaluator: Please identify the educational services your child may need. Yes No Modifications in the regular classroom Yes No Gifted & talented instruction Yes No Special education instruction Yes No Has this student been retained? If yes, list grade level(s) Yes No Has this student ever been suspended, expelled and/or attended an alternative education program for disciplinary reasons? If yes, explain Yes No Has this student ever been cited for failure to attend school or truancy? Parent Signature: Date:

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