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Welcome to Maine-Endwell Central School District,

The online registration process will give us the initial information we need to enroll your student. During this process you will be asked to securely upload the following documents that are needed for registration:

Birth Certificate or Passport

(2) Proofs of Residency forms (mortgage, rental agreement, utility bill)

Proof of Immunizations

Registration Assistance

For technical assistance or any other questions, please contact our registrar at registration@me.stier.org. If you would like to book an in person appointment with our registrar, please schedule it by using the link below:

Schedule In Person Registration Appointment

Thank you for enrolling at Maine-Endwell Central School District. We look forward to meeting you.

Student's last name *

Student's first name *

Student's middle name *

Student's date of birth *

Student's gender *

Male

Female

Non-Binary

Student's 10 Digit Cell Phone # (Number)

Has the student ever attended a Maine-Endwell Central School before? *

Yes

Primary contact's first name *

Primary contact's last name *

Primary contact's relationship *

Mother

Father

Other

Primary contact's email *

Primary contact's cell phone number *

Primary contact's work phone number

Primary contact's home phone number *

Primary contact's house number *

Primary contact's street name *

Primary contact's unit number

Primary contact's city *

Primary contact's state *

Primary contact's ZIP code *

Is the student Hispanic? *

Yes

Student's race: *

White
American Indian
Alaskan Native
Asian
Black or African American
Native Hawaiian / Other Pacific Islander

Is their a second language spoken in your home? If yes, please list the language.

Student's cell phone number

Emergency Contact First Name *

Emergency Contact Last Name *

Emergency Contact 10 Digit Home Phone Number *

Emergency Contact Relationship *

Emergency Contact may pick-up? *

Yes

Emergency contact should have Parent Portal access? *

Yes

Contact #2 First Name *

Contact #2 Last Name *

Contact #2 10 digit phone number *

Contact #2 relationship to student *

Contact #2 may pick up *

Yes

Contact #2 should have Parent Portal Access *

Yes

Contact #3 First Name

Contact #3 Last Name

Contact #3 10 digit phone number

Contact #3 may pick up

Yes

Contact #3 relationship to student

Contact #3 should have Parent Portal access

Yes

Contact #4 First Name

Contact #4 Last Name

Contact #4 10 digit phone number

Contact #4 relationship to student

Contact #4 may pick up

Yes

Contact #4 should have Parent Portal Access

Yes

Please list all children under 21 currently living within the household include grade and date of birth. *

Please list any schools previously attended including location and year(s). *

Do you have reason to believe that you/your family is in a "temporary housing situation? *

Yes

Is the student currently under foster care? *

Yes

Does the student have an IEP (Individualized Education Program) or a 504 plan? *

Yes

Is the student receiving RTI services? *

Yes

Are there any subject areas in which the child has had difficulties? If so, which ones? *

Has the student been retained in any grades? If so, which ones? *

Is there anything you think school personnel should know?

Has the student ever received any of the services listed? *

Speech Therapy
Occupational Therapy
Physical Therapy
Evaluations
Psychological Counseling
Skilled Nursing
Special Transportation
None

Transportation Information:

Indicate HOME, SITTER, NONE below for AM.

Monday	Tuesday	Wednesday	Thursday	Friday

Indicate HOME, SITTER, NONE below for PM.

Monday	Tuesday	Wednesday	Thursday	Friday

Babysitter Information (if applicable)

Please give full address of the sitter including City, State, Zip.

Sitters phone number

Sitters first & last name

Do you give your child permission to be photographed or filmed by members of the media, organizations or agencies at school or district events, for use in publications, websites, social media platforms or video? *

Yes, I do give permission for my child to be photographed or filmed by members of the media, organizations or agencies at school or district events—for use in publications, websites, social media platforms or video.

No, I do not give permission for my child to be photographed or filmed by members of the media, organizations or agencies at school or district events—for use in publications, websites, social media platforms or video.

Health Information:

Does the student take any medications daily? *

Yes

Has the student ever had allergies? (food, insect or other?) *

Yes

Has the student ever had diabetes? *

Yes

Has the student ever had convulsions, seizures, epilepsy? *

Yes

Has the student ever had asthma? or other respiratory conditions? *

Yes

Has the student ever had fainting episodes? *

Yes

Has the student ever had mental health conditions? *

Yes

Has the student ever had kidney or bladder conditions? *

Yes

Has the student ever had GI conditions? (stomach, ulcer, IBS, reflux) *

Yes

Has the student ever had a heart condition? (murmur, chest pain, high blood pressure) *

Yes

Has the student ever had a head injury? (or concussion?) *

Yes

Has the student had a nose fracture or frequent/severe nose bleeds? *

Yes

Has the student ever had surgery or been hospitalized over night? *

Yes

Has the student ever had arthritis? *

Yes

Has the student ever had back or neck conditions? *

Yes

Has the student ever had headaches/migraines? *

Yes

Has the student ever had eye conditions? (or vision loss in one or both eyes?) *

Yes

Has the student ever had ear conditions? (or hearing loss?) *

Yes

Does the student have regular dental checkups? *

Yes

Dentist First and Last Name/address

Physician First and Last Name/address

Is there anything else you think the school nurse should know?

To complete this process, you will be asked to securely upload the following documents that are needed for registration:

Birth Certificate or Passport

(2) Proofs of Residency forms (mortgage, rental agreement, utility bill)

Proof of Immunizations

Please attach your students immunization records and health exam.

List of Allowed file types

Place of Birth:

Please submit your students Birth Certificate.

Place of Birth: Attach Birth Certificate here: *

List of Allowed file types

Acceptable Proof of Residency

Need (2) forms of acceptable proofs of residency dated within the past 2 months.

Must have:

A copy of residential lease or proof of ownership of a home, such as a deed or a mortgage statement.

And (1) of the following:

Official driver’s license, learners permit or non-driver Identification.

Utility or other bill (NYSEG, Spectrum, or a garbage service).

Voter registration

Car/ renters/ homeowners insurance.

Pay stub

Tax form

Bank statement

Documents issued by federal, state, or local agencies (such as from a local social services agency).

Evidence of custody of the child, including but not limited to judicial custody orders or guardianship papers.

*We cannot accept a copy of an envelope that has been mailed to you. We will need a full copy of the document inside. *

Please attach your first proof of residency: *

List of Allowed file types

Please attach your second proof of residency: *

Add attachment

List of Allowed file types

If there is a custody agreement or foster care paperwork, please attach all documents here:

List of Allowed file types

Acceptance *
By signing below, I certify that all information provided is accurate and that I have not knowingly or intentionally provided false information in an attempt to mislead or deceive Maine-Endwell Central School District or its employees responsible for the collection of such information.

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Maine-Endwell District Registration Form