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Granger High School

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Name of Previous School(Required)

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Was this the last school you attended?(Required)

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Which school did your student attend last year?(Required)

Granger High School

Granite Park Junior High

Valley Junior High

West Lake STEM Junior High

Other

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Has the student ever been enrolled in Granite District?

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Has the student ever been enrolled in Granite District?(Required)

Yes

No

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Granite District school most recently attended:

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Last year attending that school:

Address of Previous School(Required)

City State / Province / Region Country

Previous School Email (If Known)

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Previous School Fax

Student Information

Student's Legal Name(Required)

First Middle Last

Student Gender(Required)

Male

Female

Student's Birthdate(Required)

Month

Day

Year

Student's Home Address(Required)

Street Address City ZIP Code

Home Phone

Granite District Student Number:

(If Known) This is often referred to as the student’s “9 number.” It’s a 7-digit number that begins with a 9.

Race/Ethnicity

Is this student Hispanic/Latino?(Required)

Yes

No

Which of the following groups describe the student's race?(Required)

Asian

Black

Caucasian

Native American

Pacific Islander

Native American Tribal Information

Goshute

Navajo

Paiute

Northwest Band Shoshone

Ute

Other

General Information:

Does this student reside in a single parent home?(Required)

Yes

No

Does the student have healthcare needs?(Required)

Yes

No

List special needs:

Has the student received special ed/504 services?(Required)

Yes

No

Does your family come from a refugee background?(Required)

Yes

No

What was the first language the student learned to speak?(Required)

English

Spanish

Other

What is the language spoken most often by the student?(Required)

English

Spanish

Other

What is the language most often spoken in the home?(Required)

English

Spanish

Other

What language do you prefer for school home communication?(Required)

English

Spanish

Other

PARENT/GUARDIAN NAME(S) AND ADDITIONAL CONTACTS

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Parent/Guardian Name #1(Required)

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Untitled

Parent/Guardian Name #1(Required)

First Last

Relation(Required)

Lives With

Yes

No

Release (Can the student be checked out by this individual?)

Yes

No

Home Phone(Required)

Work Phone

Cell Phone

Parent/Guardian Name #2

Relation

Lives With

Yes

No

Release (Can the student be checked out by this individual?)

Yes

No

Home Phone

Work Phone

Cell Phone

Parent/Guardian Name #3

Relation

Lives With

Yes

No

Release (Can the student be checked out by this individual?)

Yes

No

Home Phone

Work Phone

Cell Phone

PERSON TO CALL IN EMERGENCY WHEN PARENT CANNOT BE REACHED

Name of Emergency Contact #1(Required)

First Last

Home Phone(Required)

Work Phone

Cell Phone

Name of Emergency Contact #2

First Last

Home Phone

Work Phone

Cell Phone

Name of Emergency Contact #3

First Last

Home Phone

Work Phone

Cell Phone

Siblings in District

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

Sibling Name

Birth Date

Month

Day

Year

Final Section

Parent/Guardian(Required)

Please type your name to indicate the information on this form is accurate.

Email(Required)

This email address will be used to send your student’s class schedule.

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Granger High School

3580 S. 3600 W,

West Valley City, UT 84119

Main: (385) 646-5320

Attendance: (385) 646-5337

Career Center: (385) 646-5324

Counseling Center: (385) 646-5321

Contact By Email

Schedule A Tour/Visit To Our School

Educator Licensing

- Utah State Board of Education (USBE)’s administrative rule R277-301 : Educator Licensing.

Non-Discrimination Statement

Granite School District prohibits discrimination, harassment (including sexual harassment), or retaliation on the basis of race, color, sex, pregnancy, religion, national origin, marital status, disability, sexual orientation, gender identity or any other legally protected classification in all educational programs, activities, admissions, access, treatment, or employment practices and provides equal access to scouting groups and other designated youth groups. Related inquiries and complaints may be directed to a school administrator or to Karly Chavez, Title IX Coordinator, 504 Coordinator, and Director of Educational Access & Opportunity, (385) 646-5000. You may also contact the Office for Civil Rights, Denver, CO, (303) 844-5695. Read Policy V.C.1.

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