Registration Card(2) "*" indicates required fields Has the student ever been enrolled in Granite District?* Yes No Granite District school most recently attended:Academy ParkArcadiaArmstrongBacchusBeehiveBennionBridgerCopper HillsCottonwoodCrestviewDiamond RidgeDriggsEastwoodElk RunFarnsworthFox HillsFremontFrostGourleyGrangerHillsdaleHillsideHunterJacklingLake RidgeLincolnMagnaMill CreekMonroeMorningsideOakridgeOakwoodOquirrh HillsOrchardPennPleasant GreenPlymouthRedwoodRolling MeadowsRooseveltRosecrestSandburgSilver HillsSmith, CalvinSouth KearnsSpring LaneStansburyTaylorsvilleTrumanTwin PeaksUpland TerraceValley CrestVistaWest KearnsWest ValleyWestbrookWestern HillsWhittierWilsonWrightOtherLast year attending that school: Student's Legal Name* First Last Middle MiddleStudent Gender* Male Female Student's Birthdate* Month Day Year Race/EthnicityIs this student Hispalnic/Latino? Yes No Which of the following groups describe the student's race? Asian Black Caucasian Native American Pacific Islander Native American Tribal Information Goshute Navajo Paiute Northwest Band Shoshone Ute Other General Information:Student's Home Street Address City ZIP Code Home PhoneDoes this student reside in a single parent home? Yes No Does the student have healthcare needs? Yes No List special needs: Has the student received special ed/504 services? Yes No What was the first language the student learned to speak?* English Spanish Other What is the language spoken most often by the student?* English Spanish Other What is the language most often spoken in the home?* English Spanish Other What language do you prefer for school home communication?* English Spanish Other ***PARENT/GUARDIAN NAME(S) AND ADDITIONAL CONTACTS***Parent/Guardian Name #1 Relation Lives With Yes No Release (Can the student be checked out by this individual?) Yes No Home PhoneWork PhoneCell PhoneParent/Guardian Name #2 Relation Lives With Yes No Release (Can the student be checked out by this individual?) Yes No Home PhoneWork PhoneCell PhoneParent/Guardian Name #3 Relation Lives With Yes No Release (Can the student be checked out by this individual?) Yes No Home PhoneWork PhoneCell Phone******PERSON TO CALL IN EMERGENCY WHEN PARENT CANNOT BE REACHED******Name of Emergency Contact #1 First Last Home PhoneWork PhoneCell PhoneName of Emergency Contact #2 First Last Home PhoneWork PhoneCell PhoneName of Emergency Contact #3 First Last Home PhoneWork PhoneCell PhonePrevious School AttendedSchool Address Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Siblings in DistrictSibling Name Birth Date Month Day Year Sibling Name Birth Date Month Day Year Sibling Name Birth Date Month Day Year Sibling Name Birth Date Month Day Year Sibling Name Birth Date Month Day Year Final SectionParent/Guardian Signature* Please type your name to indicate the information on this form is accurate.Email*