Enrollment Form
jQuery Time Picker

Fort Cobb-Broxton High School Enrollment

Welcome to our On-line Enrollment Page. This Page is for High School Students ONLY, if you are looking for Middle School or Elementary enrollment please navigate to their respective page. One student per form, please take the time to read through the FYI section. Also once you start the enrollment form it does not save until you submit. You may want to glance through the form and gather all required information before you begin, please Do NOT enter incorrect information. Please check that you have answered all fields with an * and have chosen the correct answer on the yes and no radio buttons. When you begin to fill out the form, do not use the back and forward buttons on your browser toolbar, if you do you will lose your work. Remember the form does not save and will not let you submit until all required fields are complete.

Please do not submit a form with incorrect information.

Please Fill Out The Enrollment Form Below

You must have javascript and cookies enabled in order to use this form.





STUDENT'S FULL LEGAL NAME AS ON BIRTH CERTIFICATE, ADOPTION PAPERS, ETC.:
























































PERSON TO CONTACT IN CASE OF EMERGENCY:



















Who is currently enrolled at Fort Cobb-Broxton Public School District, permission is granted to the Fort Cobb-Broxton Public School District and its Board members, employees, agents, servants and representatives to use this student's name, photographic likeness, alone or in a group, in any Fort Cobb-Broxton Public School District publication, document, TV production, video or to release said names or likeness to any media outlets including, but not limited to, newspapers, magazines or TV stations for publicity and/or recognition purposes. Additionally, I extend permission to use this student's name and/or photographic likeness, alone or in a group, on the official web site of the Fort Cobb-Broxton Public School District, Facebook, or a web site available through the official web site. The official web site is owned and maintained by the District as a service to the parents, students of Fort Cobb-Broxton Public School District and can be accessed and viewed at www.fcbmustangs.com. I release the Fort Cobb-Broxton Public School District, its Board members, employees, agents, servants, representatives and all organizations and individuals related the Fort Cobb-Broxton Board of Education's Internet Network form any and all liabilities or damages that result from the use of this student's name and/or photographic likeness as described above. This permission shall remain in effect unless revoked by me and communicated to the Fort Cobb-Broxton Public School District in writing.





STAFF AGREEMENT: As Professional Educators I/We Will: Provide teaching and leadership. Make efficient use of academic learning time. Utilize up-to-date methods and practices. Seek professional improvement. Provide a high quality curriculum. Provide report cards four times a year regarding student's progress. Provide an environment conductive to learning. Maintain open lines of communication with students and parents. Seek ways to involve parents in classroom activities. Respect the students, their parents, and the diverse cultures of the school. Provide a safe, positive, healthy, well managed environment where all children are treated fairly. Demonstrate care and concern for each student. Suggest ways parents can support learning at home.

Staff Signature: Kyle Lierle















Email a copy to (optional).
* required field