Checotah High School Enrollment
9^th – 12^th Grade

Before you start:

Do Not Submit More Than One Form Per Student
Read Through Form Before Beginning Ensure You Have All Needed Information
(Incomplete forms cannot be saved)
All Fields With An Asterisk (*) Must Be Completed Before Submitting
When Form Is Completed, Click in the Box “I’m not a robot”, and Click “Submit”
You Will Know You Have Successfully Submitted Your Information When You See The Message:
“Thank you for submitting your enrollment form. It’s a Great Day to Be A Wildcat!”

Fill Out The Enrollment Form Below

Grade

Child's Legal Last Name

Child's Legal First Name

Child's Legal Middle Name

Gender

Mailing/Physical Address

Has address or phone number changed from last year?

Address

City

State

Zipcode

Student Information

Child's Social Security Number

Date of Birth

Ethnicity

Do You Have A CDIB Card?

Does Your Child Have A CDIB Card?

Is Residence on Tribal Land?

Is Residence an Individual Indian Home?

Is Residence Tribal Housing - Apartments?

Educational Services

Is Your Child Served By an IEP?

Is Your Child Served By Speech?

Is Your Child Served By Gifted/Talented?

Primary Parent/Guardian

This Parent/Guardian will receive messages from the Automated School Messaging System.

Parent/Guardian Name

Place of Employment

Phone Number

Parent/Guardian Email

Secondary Parent/Guardian

Parent/Guardian Name

Place of Employment

Phone Number

Parent/Guardian Email

Does Either Parent Work for The Federal Government?

Is Either Parent Actively Serving In Military?

Does Either Parent Work For The Creek Nation or Cherokee Tribal Employment?

Emergency Contacts

1st Emergency Contact

Phone Number

2nd Emergency Contact

Phone Number

3rd Emergency Contact

Phone Number

Does Your Child Have Any Medical Conditions?

Will Your Child Ride A School Bus?

School Messaging System

Checotah Public Schools uses an automated system to inform parents of upcoming events and emergencies.

Student Internet Agreement

By Signing Below, I Acknowledge That I have read and/or have access to The Information In The Student Internet Agreement located in Child Enrollment Information under the Parent Info Tab of the District Webpage.

PARENT/GUARDIAN (If you are under the age of 18, a parent or guardian must also read and sign this document) As the parent or guardian of this student, I have read the Terms and Conditions for Internet Access & the Discipline Policy. I understand that this access is designed for educational purposes and the Checotah Public School System has taken available precautions to eliminate controversial materials. However, I also recognize it is impossible for the Checotah Public School System to restrict access to all controversial materials and I will not hold them responsible for materials acquired on the network. Further, I accept full responsibility for supervision if and when my child’s use of the network is not in a school setting. I hereby give permission to issue access for my child and certify that the information contained on this form is correct.

Parent/Guardian: By typing your name below, you agree that this is valid as your signature

Date

Student: By typing your name below, you agree that this is valid as your signature

Date

World Wide Web and Printed Publications

I understand that my child’s artwork, writing and/or class photo will be considered for printed publication and on the World Wide Web (WWW), a part of the internet.

Other Forms

I have read and/or have access to the Parent Required Handouts section of enrollment including the FLE Confidential Information, FL Student Records, EHBDB Parental Involvement Sheets, Checotah Schools Student Handbooks, Meningococcal Disease and Vaccine Information, and Vaccination Requirements.

Student: By typing your name below, you agree that this is valid as your signature

Required Fields

High School Online Enrollment (9th through 12th Grade)

Checotah High School Enrollment 9th – 12th Grade

Checotah High School Enrollment
9^th – 12^th Grade