New Student Preregistration

Student Information
**First Name:   **Preferred Name:
**Last Name:
Middle Name:
**Date of Birth: mm/dd/yyyy
Previous School:
School Name:
**Grade Level:
**First Day of School:
Guardian Information
**First Name:
**Last Name:
**Relationship to Student:
Other Students in Family: Check this box if other members of your family are active students at schools in this district
**Desired User Name: Desired User Name for PowerSchool Login
**Phone: 999-999-9999
**Zip Code:
**Verification: I verify that the above information is correct
** Required Information