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Union-Endicott CSD New Student Registration Form Combined

Union-Endicott Central School District

Central Registration: 1100 East Main St, Endicott NY 13760  -  607-757-2346 or 607-757-3212



Welcome to the Union-Endicott 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:

  • Proof of Birth (Birth Certificate or Passport)

  • Two proofs of residency in Union-Endicott (Board Policy 7130)

  • Parent/Guardian photo identification

  • Immunization records Required Immunizations

  • Custody papers (if applicable)

 *If you have any question please contact registration at 607-757-2346 or 607-757-3212 

 

Thank you for enrolling at the Union-Endicott Central School District!


Primary Parent/Guardian

Spouse or Other Adult in the Home

Student Information

Last Name First Name Middle initial Date of Birth Age Gender Indicate IEP, 504, or NONE

Last Name First Name Address Phone number Relationship to student


Submission Public, please sign Show me how

Home Language Questionaire:

In order to provide your child with the best possible education, we need to determine how well he or she understands, speaks, reads and writes in English, as well as prior school and personal history. Please complete the sections below entitled Language Background and Educational History. Your assistance in answering these questions is greatly appreciated.

Educational History

Residency questionaire:

The answer you give below will help the district determine what services you or your child may receive under the McKinney-Vento Act. Students who are protected under the McKinney-Vento Act are entitled to immediate enrollment in school even if they do not have the documentation normally needed, such as proof of residency, school records, immunization records, or birth certificate. Students who are protected under the McKinney-Vento Act may also be entitled to free transportation and other services.

Health Requirements:

New York State Public Health Law 2164 states that a principal or person in charge of a school shall not permit a child to be admitted to school unless a person in parental relation to the child furnishes the school with proof the child has received all required immunizations. Within 14 days, I will furnish the school with a certificate of required immunizations or my child will be subject to exclusion from school.


Immunization Requirements (within 14 days):



MMR (Measles, Mumps, Rubella) - 2 doses

DTap, DTP - 4-5 doses at appropriate intervals

Polio (Salk) - 3-4 doses at appropriate intervals

Varicella - 2 doses for all grades except for grades 5,11, and 12 which require only 1 dose.

Tdap - 1 dose, students in grades 6-12

Hepatitis B - 3 doses at appropriate intervals

Meningitis - 1 dose for students entering grades 7, 8, 9 and 12 (Note for grade 12 – must have dose after 16 years of age)



Physical Examination:

The New York State Education Law and Regulations also require that all new entrants to school receive a physical examination. A completed health form must be filled out and returned to the Health Office. The examination must be performed during the calendar year of the entrance date to school and must be signed by a licensed physician, Nurse Practitioner or Physician’s Assistant, who is authorized to practice medicine in New York State.

Ideally, your family physician should perform this examination. However, the school district is mandated by law to provide a physical examination of any pupil whose parents do not provide a report from a family physician. These physicals are scheduled throughout the school year. If a student does not appear for the examination at the time he/she is scheduled, they will not be eligible to attend school the following September and thereafter unless or until a signed physical form is received by the Health Office.

If you need further information, contact the Health Office in your student’s building.

Health Sheet:


Pregnancy/Birth History

Hospitalizations and Illnesses

Health Problems

Record Release:

It is requested that an official copy of the school records of the following student be released or transferred. The union undercut central school district forwards educational records upon request to any school or agency in which a student seeks or intends to enroll.

Receiving School or Department:

Attachments:

Below you will attach any documents you have pertaining to the registration. Only the Proof of Birth and two Proofs of Residency are required at the time of registration. The other attachments are if you have them.

Some guidelines for submissions:


Proof Of Birth:

-Birth Certificate

- Passport

- Learner's Permit/Drivers license


Proof of Address:

-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.

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

-Membership documents based on residency


List of Allowed file types

List of Allowed file types

List of Allowed file types

List of Allowed file types

List of Allowed file types

List of Allowed file types