2009-2010 Registration Information 

Oliphant Administration Building 26 Oliphant Lane, Middletown, RI 02842

Registrations are by appointment only. Please call 849-2122 to schedule an appointment.

STUDENT REGISTRATION INSTRUCTIONS (print this page)

• Registration Forms Needed:

STEP 1:
o Families registering new students need to fill out only ONE Family Registration Form no matter how many children you are registering.

STEP 2:
o If you are registering a student (or students) for grade 1 through 12, print and fill out the Grade 1 through 12 registration packet. (one per student)
o If you are registering a kindergarten student, print and fill out the kindergarten registration packet. (one per student)

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PLEASE PRINT FORMS NEEDED (LISTED ABOVE) FIRST THEN FOLLOW INSTRUCTIONS LISTED BELOW

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INDIVIDUAL REGISTRATION FORM INSTRUCTIONS

• Family Registration Form Directions:
o Resident Address Information (list your Middletown street and mailing address along with home phone number)
o Head of Household Information (parent or guardian living with child) If both of the child’s parents no longer live in the same home, you can choose to list the non-custodial parent as an emergency contact)
o Emergency Contact: (list local contact other than the custodial parent or guardian)
o Preschool Children: (your other children who will eventually attend Middletown Public Schools)

• Student Registration Form Directions:

o Student Information (name, grade, gender, date of birth and the rule of thumb is if you don’t know what Special Ed ( IEP) & 504 are then the answers are N)
o Ethnic Background
o Previous School Information (we do not need pre-school information)
o Date and Sign form

•  Home Language Survey
• School Physical Form (the last physical has to be within one year of the child entering our school system, you are given six months to have it done as long as ALL immunizations are up-to-date)
• Student Health History and Release (this is a brief health history to be given to the school nurse)
• Medication Procedure and Bee Sting/Severe Allergy Procedure Form (only complete if the child is on medications that need to be taken in school – must be signed by a physician)
• Middletown Police Department (you only complete this form if you DO NOT want to be notified if a high risk sex offender moves into your neighborhood)
• Computer and Internet Acceptance Use Policy:
o Appendix 1 (by signing this side you are approving the child’s use of the computer and access to the internet.)
o Appendix 2 (by signing this side you are giving us permission to post the child’s work on our website)
• Chartwell Lunch form – (This form explains how to set up your child’s lunch account. Your will be given your child's student ID # at the time of registration. You and your child will use this number to access the online lunch system.)
(These next forms are in the kindergarten packet only)
• Kindergarten Class Placement Survey – (list strengths and weaknesses that you feel the classroom teacher should know about your child)
• Kindergarten Registration Coloring Page – (with NO help, your child needs to write his/her name at the top and draw a picture of themselves – you fill out the bottom half of form)
• Multi-Age is a three year commitment - download Multiage Brochure – (if interested in program you must include a letter to the Principal in this packet requesting your child be considered for the program.)

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REQUIREMENTS NEEDED AT REGISTRATION APPOINTMENT:
• Completed Family Registration Form (one per Family)
• Completed Student Registration Packet (one per Student)
• Student’s Birth Certificate (original, NOT souvenir)
• Student’s Immunization Records (please see requirements)
o Additional Immunization Requirements for Kindergarten Students:
-Lead Screening
-Vision Screening
• Parent Photo ID: (driver's license or military ID)
• Proof of Residency: Student must reside in Middletown with parent/guardian. A true copy of one of the following will be accepted as proof of residency ( all must be current):
A. Middletown Property Tax Bill
B. Government Housing Letter
C. Copy of Lease/Copy of Rental Agreement
D. Notarized Letter/Form from Middletown Residents with Proof of Residency
E. Current Utility Bill (Phone, Electric, or Gas)
If you live with another family member or person, they need to complete the Verification of Residency letter (download here) and come to Administration to have their signature notarized, as well as bring one of the above listed proof of residency requirements in to prove they are a Middletown Resident.

We do registrations by APPOINTMENT ONLY. Please call 849- 2122 to schedule an appointment.