2016-2017 Elementary Registration

Elementary Registration Forms

Student Information Form (Required – each student)
(Existing Mediapolis students may return their pre-printed Student Information Form which was mailed to your primary address in lieu of filling out this blank form. All new students need to complete this blank form.)
Parent Permission & Release Form (Required – each student)
(Internet & Email Usage, Field Trip Permission, and Student Handbook Acknowledgement are now available for review by clicking on the above Parent Permission & Release Form link.)
Elementary Arrival & Dismissal Form (Required – each student)
Health Update (Required – each student)
Certificate of Dental Screening  (Required – Kindergarten only)
Certificate of Immunization  (Required – Preschool & Kindergarten only)
Certificate of Vision Screening  (Required – Kindergarten & 3rd Grade only)
Home Language Survey  (Required – Kindergarten & each new student only)
Request for Records (new transfer in students only) (Required – each new student)
Elementary School Supply List  (one per family)
Fees List  (one per family)
Informational Letter Regarding Dates (one per family)
Registration Check-Off List (one per family)
Free & Reduced Meals Application (one per family)
Standard Fee Waiver Application (one per family)
Athletic Pass Order Form (one per family)
Volunteers & Chaperones (including field trips):
Volunteer Acknowledgement Form (All volunteers & chaperones) (one per person – annually)
Background Check: Authorization for Release of Child & Adult Abuse Information Forms (one per person)
A one- time background check is required on all volunteers and chaperones.
Favorable results are required prior to the school district utilizing your services.