Belle Isle Enterprise Middle School

 

Academic Year 2008-2009

 

Student Information Sheet

 

 

STUDENT’S NAME                                                                                                                                                                             

Last                                                         First                                        Middle Initial

 

PARENT/GUARDIAN’S NAME                                                                                                                                      

 

HOME TELEPHONE                                                                         WORK TELEPHONE                                                          

 

 

ADDRESS                                                                                                                                                                                              

Number                 Street                                                      Apt.                        City                         Zip Code

E-MAIL ADDRESS ____________________________________________________________________________

 

STUDENT’S BIRTH DATE:                       /           /                 SSN # ____________/________/________________                          

CURRENT GRADE LEVEL                                        OCPS STUDENT IDENTIFICATION#:                                                

 

2006-07 SCHOOL OF ATTENDANCE                                                                                                                              

 

OTHER SCHOOLS ATTENDED AND YEARS ATTENDED:  __________________________________                           

 

FOR WHAT GRADE DO YOU SEEK ADMISSION TO THE SCHOOL?  6TH _____ 7TH _____   8th _____

 

DOES THE APPLICANT HAVE A BROTHER OR SISTER ATTENDING BIEMS NOW?  Yes ___No___

                If yes, what is his/her name? _____________________________________________________

 

DOES STUDENT HAVE AN INDIVIDUAL EDUCATION PLAN PREPARED BY SCHOOL STAFF? Yes___No___

 

Information requested by OCPS and not a factor in the BIEMS selection process:

ETHNICITY: Asian __ African-American __ Caucasian __ Hispanic __  Native American __ Other ___

GENDER:   M _______ F________

PARENT/GUARDIAN ACKNOWLEDGMENT:

I wish for my child/children to attend the Belle Isle Enterprise Middle School and understand that they will be expected to adhere to all rules and regulations set forth by the Belle Isle Enterprise Middle School and the Oklahoma City School Board.

  I further understand Belle Isle Enterprise Middle School is an Oklahoma not-for profit corporation and does not discriminate against anyone on the basis of race, color, sex, religion, age, national origin, handicap, disability, or socioeconomic

 status in the application of its programs and activities.  I also understand that students will be admitted to the Belle Isle Enterprise Middle School based upon the admissions policy of the school as approved by the Oklahoma City School Board. 

I have been provided with the admissions policy summary which summarizes the admissions policy the Belle Isle Enterprise Middle School has submitted for approval by the Oklahoma City School Board.

 

PARENT’S/GUARDIAN’S SIGNATURE:                                                                                        

STUDENT’S SIGNATURE:                                                                                DATE                             

 

 

OFFICIAL USE ONLY

 

 

DATE RECEIVED:             /             /                                                                                                     INITIALS: