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~[wc:admin_header_frame_css]Start Page > Student Selection > Registration~[wc:admin_navigation_frame_css] ~[wc:title_student_begin_css]Registration~[wc:title_student_end_css] ~[if#formSubmitted.~[gpv:formSubmitted]=True]
Changes saved
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Jump to:  Parents  Emergency  State  Web Access  ~[if.pref.enroll_note_enable=1] Enrollment Notes [/if]
Note: moving your mouse over a field's title will reveal it's search term
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Name (last, first MI) ,
Lineage (Suffix)
Nickname  
Home Phone
Home Street Map
Home city, state, zip ,
Residency   Expiration date of lease if Renting
Mailing Street Map
Mailing city, state, zip ,
Area/neighborhood Date of Entry into USA
Gender Student Number (PS#)
Home Room SSN
Birth date  (mm/dd/yyyy) Directory Listing Permission
Graduation Year Photo/Video Permission
Reporting Ethnicity   Internet Use Permission
~[Comment:Note that the onload javascript will revert this back to -1 after it's been changed to whatever is currently in the DB.]
~[text:psx.html.admin_students.generaldemographics.yes]
~[text:psx.html.admin_students.generaldemographics.no]
~[if.pref.FRE_AllowDeclineEthnicity=1]
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IL Race Ethnicity:
None
District Entry Date District Entry Grade Level
CIC Student School Entry Date School Entry Grade Level
PARENT/GUARDIAN    
Lives With Family rep.
Mother's Name (Needs to be formatted like: Doe, John)
Mother's Day Phone   Cell Phone
Mother's Home Phone
Mother's Email
Mother's Employer
Mother's Maiden Name (LAST NAME ONLY)
Father's Name (Needs to be formatted like: Doe, John)
Father's Day Phone   Cell Phone
Father's Home Phone
Father's Email
Father's Employer
Guardianship       Single Parent Household
Guardian(Last, First, Middle)
Guardian's Day Phone   Cell Phone
Guardian Email
(Separate multiple emails with commas, do not include any spaces)
Guardian Alert Text
Alert Expires (date)

(0/0/0 to never expire)
EMERGENCY/MEDICAL INFO   
Emergency Contact #1
Contact #1 Phone
Contact #1 Relationship Phone Type  
Emergency Contact #2
Contact #2 Phone
Contact #2 Relationship Phone Type  
Emergency Contact #3
Contact #3 Phone
Contact #3 Relationship Phone Type  
Doctor Doctor Phone# 
Dentist Dentist Phone# 
Medical Alert Text Alert Expires (date)

(0/0/0 to never expire)
IL STATE INFORMATION    
PreK Program
Kindergarten Program
Home Language
(this value comes from the home language survey)
Native Language
(Language the student speaks, leave blank for English)
Disability
Limited English Proficient (LEP) Migrant
Low Income Family (Economically Disadvantaged) Individualized Education Plan (IEP)
11. Birth Place Name (City State Country)
 DO NOT USE COMMAS OR PERIODS
15. Eligible for Immigrant Education Program
18. Homeless Indicator
31. RCDTS Home School Number (Student Level) Enter if home school is different from current PS school
26. 504 Accommodation Indicator
32. RCDTS Serving School Number Enter if serving school is different from current PS school
35. Full Time Equivalent (FTE)
(Note: Enter a value less than or equal to one.)
WEB ACCESS    
Enable Parent Access
Parent Access ID
Parent Access Password
Student Access, Allow
Student Username
Student Password
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