registration checklist for ecdd students - St. Joseph Public Schools
registration checklist for ecdd students - St. Joseph Public Schools
registration checklist for ecdd students - St. Joseph Public Schools
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AUTHORIZATION TO RELEASE SCHOOL RECORDS<br />
Great <strong>Schools</strong> in a Great Community<br />
STUDENT’S NAME______________________________________________________________<br />
DATE OF BIRTH________________ PRESENTLY ENTERING GRADE____________________<br />
PREVIOUS SCHOOL____________________________________________________________<br />
SCHOOL ADDRESS_____________________________________________________________<br />
CITY/STATE/ZIP CODE__________________________________________________________<br />
PHONE NUMBER_________________________ FAX NUMBER_________________________<br />
Is hereby authorized to make the following in<strong>for</strong>mation available to <strong>St</strong>. <strong>Joseph</strong> <strong>Public</strong> <strong>Schools</strong>.<br />
• All School Records (including special education records)<br />
• Health and Immunization Records<br />
• <strong>St</strong>udent Discipline Records<br />
• Semester Grades and Withdrawal Grades<br />
Please <strong>for</strong>ward in<strong>for</strong>mation to the following:<br />
Y5s/KINDERGARTEN/GRADES 1-5:<br />
_____Brown Elementary, 2027 Brown School Road, <strong>St</strong>. <strong>Joseph</strong>, MI 49085<br />
_____E. P. Clarke Elementary, 515 East Glenlord Road, <strong>St</strong>. <strong>Joseph</strong>, MI 49085<br />
_____Lincoln Elementary, 1102 Orchard Avenue, <strong>St</strong>. <strong>Joseph</strong>, MI 49085<br />
After June 15: (Grades K-8)<br />
<strong>St</strong>. <strong>Joseph</strong> <strong>Public</strong> <strong>Schools</strong><br />
Curriculum Office<br />
3275 Lincoln Avenue<br />
<strong>St</strong>. <strong>Joseph</strong>, MI 49085<br />
(269) 926-3100<br />
Fax: (269) 926-3103<br />
GRADES 6-8: GRADES 9-12:<br />
Upton Middle School<br />
<strong>St</strong>. <strong>Joseph</strong> High School<br />
Jennifer Ruddell<br />
Allison Koch<br />
800 Maiden Lane 2521 <strong>St</strong>adium Drive<br />
<strong>St</strong>. <strong>Joseph</strong>, MI 49085 <strong>St</strong>. <strong>Joseph</strong>, MI 49085<br />
(269) 926-3400 (269) 926-3200<br />
Fax: (269) 926-3403 Fax: (269) 926-3203<br />
_____________________________________<br />
Signature of Parent or Guardian<br />
_________________________________<br />
Date<br />
It is the policy of the <strong>St</strong>. <strong>Joseph</strong> <strong>Public</strong> School District that no person shall, on the basis of race, color, religion, national origin or ancestry, sex, disability, height,<br />
weight, genetic in<strong>for</strong>mation, or marital status be excluded from participation in, be denied the benefits of, or be subjected to, discrimination during any program,<br />
activity, service or in employment.<br />
Brown School ● 2027 Brown School Road ● <strong>St</strong>. <strong>Joseph</strong>, MI 49085 ● (269) 926-3500 ● FAX-(269) 926-3503
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