Prior Enrollment Information
Has this student or his/her elder sibling ever enrolled in District 214?
*
 
Multiple (Twin/Triplet) Students Enrollment Information
Are you registering multiple 9th Graders for School Year 22-23?(*Please use same Primary phone for all siblings)
*
 
Legal Student Name (as it appears on Birth Certificate, no nickname or short name)
Student First Name: *   Middle Name:  
Student Last Name: *   Suffix: Ex: III, Sr, Jr  
Home Address: * Apt #:
City:
*  
State :
Zip Code:
*  
*   *   Ex: 99999 or 99999-9999
Primary Phone: *   Unlisted:
Gender:
*  
Student Cell Phone:


Race Ethnicity
Part A. Is this student Hispanic/Latino? Please choose one. *   Race Ethnicity Questions        
Part B. What is the student’s race? Choose one or more. *    
Birth Information
Date:  *   Town / City:  *
Country: * US State: *
Select Current junior high/middle school attended:
  *  
Other:
Address :   City:  
State / Country:   Zip Code:    
School you will attend: *  
Please choose the 9th grade placement test date your student plans to attend.
Please verify all information on the page before proceeding to next page.