Enrollment for Current Family with New Student

Parent/Legal Guardian First Name *

Last Name *

Relationship to Student *

Street Address *

City *

State *

Zip Code *

Phone Number *

Email Address *

Spouse First Name

Last Name

Phone Number

Email Address

Student First Name *

Last Name *

Student Date of Birth *

Race *

Ethnicity *

Hispanic

Non-Hispanic/Latino

Enrolling Grade *

Records Request for students enrolling in grades 1-12. Please copy and paste the following link into your web browser and complete the form so we may obtain your student's records. https://fs9.formsite.com/WgL6Mt/yzzevervjj/index.html *

Enrolling Year *

Foster Child *

Yes

No

Gender *

Does the student speak a language other than English? *

Yes

No

Home Language *

Has this student received special services (504, IEP, Speech, ELL or Gifted) at their previous school? *

Has this student ever been suspended or expelled from a school? *

Yes

No

If yes, please explain:

I hereby certify and represent to the School District of Webster Groves, for the purposes of the
Missouri Safe Schools Act, that:
This student has not been convicted or indicted of any of the following offenses, and no information or petition alleging such offense has been filed:
a. first-degree murder under Section 565.020, RSMo.
b. second-degree murder under Section 565.021, RSMo.
c. first-degree assault under Section 565.050, RSMo.
d. forcible rape under Section 566.030, RSMo.
e. forcible sodomy under Section 566.060, RSMo.
f. robbery in the first degree under Section 569.020, RSMo.
g. distribution of drugs to a minor under Section 195.212, RSMo.
h. arson in the first degree under Section 569.040, RSMo.
i. kidnapping, when classified as a Class A felony, under Section 565.100, RSMo. *

Yes

No

Current Utility Bill (last 30 days) *

Immunizations *

Birth Certificate *

Are there any court order documents currently in effect for this student? *

Yes

No

Other (parenting plan, court orders etc.)

Thank you for enrolling in the Webster Groves School District. Please be sure you have completed the records request form. When your enrollment is complete and your records have been received, you will receive a link to complete your school registration, and your student will be able to start school.