PreRegistration Form for New Students.pdf - Google Drive

Lunenburg Public Schools www.lunenburgonline.com

Loxi Jo Calmes Superintendent 1025 Massachusetts Avenue Lunenburg, MA 01462 Tel. (978) 582-4100 Fax: (978) 582-4103

Welcome to Lunenburg! To begin your child’s registration process, please fill out the following, and return to the main office of the attending school with the documents indicated below: Student’s First Name: Student’s Middle Name: Student’s Last Name: Student’s Gender: M / F Student’s date of Birth:

Grade Level:

Parent / Guardian’s Name: Parent / Guardian’s Email Address: Parent / Guardian’s Contact Number: Documents needed: 1. 2. 3. 4. 5. 6. 7. 8. 9.

Parent Staff

Photo ID of parent/legal guardian Your child’s birth certificate Health Insurance information Copy of latest Report Card / Transcripts/Grades Copy of current Individual Educational Program or 504 Plan (if applicable) Individual Health Care Plan (if applicable) Legal Custody From ( if applicable) Copy of School Health Record, Copy of most Recent Physical, and Immunizations Proof of Residency – See Information Below

All applicants must submit at least three proofs of residency, one from each column below. Documents must be pre-printed with the name and address of student’s parent/guardian and must be presented at the time of registration. These documents are also required for any change of address or for re-enrollment. Column A

Column B

Column C

Copy of most recent mortgage payment

Utilities Bill (Gas, Oil, Electric or Water)

Copy of current Purchase & Sale Agreement

Telephone or Cellphone Bill

Copy of Lease (including HUD leases) and record of most recent rent payment Notarized legal affidavit from landlord affirming tenancy and record of most recent rent payment

Cable or Internet Bill or work order House or Rental Insurance Bill or Statement Credit Card or Bank Statement

Valid MA Photo Driver’s License with Lunenburg Street Address not just a P.O. Box. Current MA Vehicle Registration with Lunenburg Street Address not just a P.O. Box Valid MA Photo Identification Card with Lunenburg Street Address not just a P.O. Box.

Section 8 Agreement

Current W2 Form Current Excise (vehicle) Tax Bill Current Property Tax Bill Letter from approved government agency (DFS) Credit Card or Bank Statement

For Office Use Only (Do not complete until all documents above are received): Student LASID Number: Student SASID (if known): Date of Enrollment: Grade Level: Date of Entry into Student Information System: Date of Notification to complete PowerSchool Registration: