West Islip Public Schools
The Michael and Christine Freyer Administration Building
100 Sherman Avenue, West Islip, New York 11795
TEL: (631) 893-3200 ⋅ FAX: (631) 893-3212
 
THIS FORM MUST BE COMPLETED BY THE PARENT OR GUARDIAN OR PERSON IN PARENTAL RELATIONSHIP.
 
You can create an account (located at the bottom) and save the form as you are filling it out. 
 
Registration is not complete until all requested forms have been received by the District Office during your appointment and the health information is confirmed by the school nurse.
Type of registration: *
Student's Sex: *
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Was the student born in the U.S.? *
Is the student Hispanic, Latino, or of Spanish origin? * 🛈
Select one or more races from the following five racial groups: * 🛈
0/50 characters
0/50 characters
Are both parent's living in the home? *
Check all that apply: *
1st Parent's Phone Numbers (Include Area Code) * 🛈
 HomeCellWork
1st Parent
0/50 characters
Is the 1st Parent a Non-Custodial Parent (entitled to receive mail)? *

2nd Parent's Phone Numbers (Include Area Code) * 🛈
 HomeCellWork
2nd Parent
0/50 characters
Is the 2nd Parent a Non-Custodial Parent (entitled to receive mail): *
Are you a guardian other than the mother or father of the child? *
Guardian's Phone Numbers (Include Area Code) * 🛈
 HomeCellWork
Guardian
0/50 characters
Do you have other children that are residents of the home? *
Additional Siblings
 First Name:Last Name:D.O.B (MM/DD/YY)Gender:
1.
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6.
Has any adult had a major part of your child’s care other than 1st or 2nd Parent? *
If yes, give names and relationships to your child. 🛈
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Are either of the student’s parents or guardians on active duty in the Armed Forces? * 🛈
Is this application being filed by someone other than a natural, adoptive or step-parent? *
0/255 characters
Does the student live in your home exclusively? *
Is this a temporary or permanent relationship? *
Do you have legal authorization to make medical decisions for the child for physicians and hospitals? *
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