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Student Information/Demographics

(From Birth Certificate)
(Last)
(First)
(Middle)
(Optional)




SECTION TWO - PARENT/GUARDIAN INFORMATION

Please note that if the Student's address has changed in the past year they will be required to complete a New Student Enrollment Form and submit new proof of residency
(Last)
(First)

10/20/2017

SECTION THREE - DISCLAIMERS

,

Michigan State Required Testing

It is mandatory that students in our program participate in state and federal testing during required dates. Please note that families are also responsible for travel costs associated with commuting to our physical building location(s) for orientation(s), state and federal testing purposes, and any other required activity. Families should consider travel limitations before enrolling at our school.




If yes, who is not allowed to have contact with the student?
***NOTE*** The school must have a copy of the order to deny release/contact to a parent.

As the Parent/Guardian of this student, I have received the UNDERSTANDING CONCUSSION information. By my name and signature on this form, I acknowledge in accordance with Public Acts 342 and 343 of 2012 that I have received and reviewed the Concussion Fact Sheet for Parents and/or the Concussion Fact Sheet for Students provided by Harper Woods Returning .


Please review: Network And Internet Access Agreement for Students







Please Read: Presenting false information, false records or falsifying records is an offense punishable by federal and state law. By signing below, you attest that all information provided on this form is true and accurate.
Parent/Legal Guardian Signature (or Student if 18 or over)
Date
Press/Video Release

Harper Woods Returning Schools has my permission to use photographs and/or videos of my child to show school activities to the public. I understand that the personally identifiable information may be used at the discretion of the media, involving no financial compensation to Harper Woods Returning Schools , the student, or the family of the student. The final edited pictures and sounds may be shown without restriction, including radio and television broadcast, cablecast, printed publication, website and any other social media. I understand that I have the right to deny consent to the release of the photographs and/or information specified above, by refusing to sign this. If you consent, please sign here:


Date
If permission is denied, please write “DENIED” on the signature line

Please Read: Presenting false information, false records or falsifying records is an offense punishable by federal and state law. By signing below, you attest that all information provided on this form is true and accurate.

FILE UPLOADS

Required Documents:

Birth Certificate

Picture I.D.

Proof of Residency (Utility Bill, Lease Agreement)

Shot/Immunization Record

All High School Transcripts

Upload Your Documents

To help expedite your application process, we give you the option to upload digital versions of any or all of these documents onto our secure, encrypted servers.

Once your files are received, they will be removed from the site and stored in our office.

Depending on the district, you may be asked for other documents.

To upload your files, check the boxes above to indicate which documents you are including then select the files on your computer in the popup window after clicking 'Upload Your Documents'

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