Registration Form

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Student Name*

First Middle Last

Charleston County School District Registration Form

Grades PRE(K)-12

Grade Registering for*

Previous Grade Level*

Student Information

Student's Legal Name*

First Middle Last Suffix

Student's Preferred Name*

Date of Birth*

MM

DD

YYYY

Gender*

Is the student Hispanic or Latnio?*

Race: (Check all that apply.)*

American Indian or Alaskan Native
Asian
Black or African American
Native Hawaiian or Other Pacific Islander
White

Home Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Area/ Neighborhood

Home Phone*

Daytime Phone (For absence calls)*

Evening Phone (For absence calls)*

Mailing Address (If Different)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Primary Email Address*

Secondary Email Address

Is the current residence temporary?*

Is the student an unaccompanied youth?*

Is the student an emancipated minor? (If yes, legal documentation must be provided.)

Upload Legal Documentation of Emancipation

Is the current residence a group home or residential treatment facility?

Facility Name

Is the current residence a foster home?

Does the student live outside of Charleston County but own real property in Charleston County with an assessed value of $300 or more in Charleston County

(If yes, provide the address of the property.)

Real Property Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

If your child was not born in the United States, in what country was he/she born?

What date did your child first begin school in the United States?

MM

DD

YYYY

Family Information

Parent/ Guardian Military Status

Neither Parent of Guardian is serving any military service
The National Guard but is not deployed
The Reserves but is not deployed
The National Guard and is currently deployed
The Reserves and is currently deployed
The military on active duty but is not deployed
The military on active duty and is currently deployed
A Parent or Guardian died on active duty within the last year
A Parent or Guardian was wounded while on active duty within the last year

With whom does the student live?

Are there any custody issues we should be made aware of?

(If yes, legal documentation must be provided to the school)

Parent/ Guardian #1

First Last Suffix

Relationship to Student

Home Phone

Cell Phone

Day Phone

Lives with student

Home Address, if different from student's

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Parent/Guardian #1 Employer

Work Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Is Parent/Guardian #1 employed by CCSD?

CCSD Employee No.

Work Location

Does this parent receive mailings?

Does the Parent/ Guardian have custody of the child?

Parent/ Guardian #2

First Last Suffix

Relationship to Student

HomePhone

Cell Phone

Day Phone

Lives with student

Home Address, if different from student's

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Parent/Guardian #2 Employer

Work Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Is Parent/Guardian #2 employed by CCSD?

If yes, provide the following:

CCSD Employee No.

Work Location

Does this parent receive mailings?

Does the Parent/ Guardian have custody of the child?

Siblings

Sibling Name

First Last

Date of Birth

MM

DD

YYYY

Age

Grade

School

Sibling Name

First Last

Date of Birth

MM

DD

YYYY

Age

Grade

School

Sibling Name

First Last

Date of Birth

MM

DD

YYYY

Age

Grade

School

Scholastic Information

Previous School

Previous School Name

Address

City State / Province / Region

Has a student repeated a grade?

If yes, grade(s) repeated

Has a student been expelled?

If yes, grade(s) expelled

Did the student attend Kindergarten?

Does the student have any of the following designations?

Check all that apply.

504 Plan
Gifted/ Talented
ESOL
Migrant
Student Transwer

Does the student have an Individualized Education Program (IEP)?

If yes, specify the instructional setting.

General Education
Separate class
Separate school
Other

If other, please explain.

Is transportation listed as a related service in the student's IEP?

If the student has an IEP, please specify the area of disability:

Check all that apply.

Other (Please Specify)

Transportation Information

How will the student get to school in the morning?

AM Bus Only
AM & PM Bus
POV (Car Rider)
Daycare provides
PM Bus Only
Walker
Bicycle

How will the student get home in the afternoon?

AM Bus Only
AM & PM Bus
POV (Car Rider)
Daycare provides
PM Bus Only
Walker
Bicycle

Parent/ Guardian Signature

Date

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Charleston County School District Registration Form

Student Information

Family Information

Siblings

Scholastic Information

Transportation Information