Sand Pine Elementary School 2022-2023 Enrollment Request

The Registrar will need to contact you with directions for completing the enrollment process. Please be sure to give phone numbers and email addresses that you monitor. This form is for new 1st through 5th grade students.
Thank you

Student Name Student Name First Last
Date of Birth Date of Birth / MM / DD YYYY
Grade (2022-2023)

Grade (2022-2023) 1st 2nd 3rd 4th 5th
Previous School
Previous School County
Previous State

Please answer the following questions:
Please answer the following questions:	Yes	No
Is your child in a Special Education Program?	Is your child in a Special Education Program?Yes	Is your child in a Special Education Program?No
Does your child have an IEP?	Does your child have an IEP?Yes	Does your child have an IEP?No
Does your child have a 504 plan?	Does your child have a 504 plan?Yes	Does your child have a 504 plan?No
Is your child in the English as a Second Language Program?	Is your child in the English as a Second Language Program?Yes	Is your child in the English as a Second Language Program?No

Parent #1 Name Parent #1 Name First Last
Parent #1 Address Parent #1 Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Parent #1 Phone Parent #1 Phone - ### - ### ####
Parent #1 Email
Parent #2 Name Parent #2 Name First Last
Parent #2 Address Parent #2 Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Parent #2 Phone Parent #2 Phone - ### - ### ####
Parent #2 Email
Spam Protection. Please answer this simple question:
In the number 77283, what is the 4th digit?