New Students Only - Preregistration


Student Information
Legal Name from Birth Certificate
**Legal Name: **First: Middle: **Last:
**Date of Birth: mm/dd/yyyy
**Gender:
Preferred First Name:
**School:
**Previous School:
Enter NONE in all three boxes
if Kindergarten student
School Name:
City:
State:
**Grade Level:
**Anticipated Start Date:
Current Special Programs IEP 504 ELL Speech Therapy
**School Year
**Has this child ever previously Hawthorn
including Early Childhood/PreK?
**Are you interested in the
School of Dual Language?
Sibling 1 First Name
Only required if you are interested in the School of Dual Language.
Sibling 1 Last Name
Only required if you are interested in the School of Dual Language.
Sibling 1 School
Only required if you are interested in the School of Dual Language.
Sibling 2 First Name
Only required if you are interested in the School of Dual Language.
Sibling 2 Last Name
Only required if you are interested in the School of Dual Language.
Sibling 2 School
Only required if you are interested in the School of Dual Language.
Parent/Guardian Information
**First Name: **Last Name:
**Relationship to Student:
Other Students in Family: Check this box if other members of your family are active students at our schools
**Desired User Name: Desired User Name for PowerSchool Login
**Email:
**Phone: 999-999-9999      Alternate Phone: 999-999-9999
**Street:
**City:
**State:
**Zip Code:
Rental Property Owner's Name Use only if renting or leasing
2nd Parent/Guardian First Name
2nd Parent/Guardian Last Name
2nd Parent/Guardian Relationship to Student
2nd Parent/Guardian Email
2nd Parent/Guardian Phone
2nd Parent/Guardian Street
2nd Parent/Guardian City
2nd Parent/Guardian State
2nd Parent/Guardian Zip
**Verification: I verify that the above information is correct
** Required Information