Student Enrollment Form

Student Information

School Name

Grade

First Name

Middle Name

Last Name

Generation (Jr., etc)

Legal sex (F/M/X/N)

Date of Birth

Affirmed First Name (optional)

Affirmed Middle Name (optional)

Affirmed Last Name (optional)

Affirmed Gender (optional) (F/M/X/N)

Student's siblings names if currently enrolled in cps

Personal Information

Birth Certificate On File

Birth Verification Type

Birth State

Birth City

Birth Country (Complete if student was not born in the United States (US) or one of its Territories)

Physical (HOME) Address (include unit number if applicable)

City

State

Zip

Home Phone

Mailing Address (if different than Home and include unit number if applicable)

City

State

Zip

Enrollment

School Transferring From (if not a Chicago Public, Charter or Contract School)

City and State

Is the student in good standing?

Last chicago public, charter or contract school attended

Is the student receiving any type of special education services?

Student enrolled by (Print name and relationship)

Required Documents

Documents can be attached on the site and uploaded or emailed to enrollment@graderesults.com or faxed to 866.937.8871, or mailed to Grade Results at 1316 Newport Dr., Carrollton, TX 75006.

Birth Certificate

Social Security Card

Proof of Residence

Proof of Immunization and Health Screenings

Prior Academic Records

IEP/504 Documentation

Transcript Documentation

Other Documents for Special Circumstances

Custody order, Gifted documentation, Special Education Documentation: IEP Documentation: Supporting Evaluation Documentation, IEP Exit Documentation, 504 Plan

Select Document

Student Enrollment Form

Student Information

Personal Information

Enrollment

Required Documents

To be filled by Parent/Guardian

Student Signature

Parent Signature