New Student Packet

Mother's Name*
First Last
Mother's Phone*
Mother's Email*
Mother's Address same as Student?*
- Yes
- No
Mother's Address*
Street Address Address Line 2 City State ZIP Code
Mother's Occupation
Mother's Employer
Father's Name*
First Last
Father's Phone*
Father's Email*
Father's Address same as Student?*
- Yes
- No
Father's Address*
Street Address Address Line 2 City State ZIP Code
Father's Occupation*
Father's Employer

What is the native language of the student?*
What language(s) is spoken most often by the student?*
What language (s) is spoken by the student in the home?*
If a language other than English is indicated for any of the questions above, the student is considered to be a language minority student. Once this determination has been made, an English proficiency assessment must be administered to the student within 30 days of the start of school (or within 2 weeks for late enrollees) and annually thereafter to assess the level (1-5) of English proficiency and measure growth annually. For more information, you can visit the Indiana Department of Education’s Division of Language Minority and Migrant Programs website at: http://www.doe.state.in.us/lmmp/welcome.html*
If a language other than English is indicated for any of the questions above, the student is considered to be a language minority student. Once this determination has been made, an English proficiency assessment must be administered to the student within 30 days of the start of school (or within 2 weeks for late enrollees) and annually thereafter to assess the level (1-5) of English proficiency and measure growth annually. For more information, you can visit the Indiana Department of Education’s Division of Language Minority and Migrant Programs website at: http://www.doe.state.in.us/lmmp/welcome.html
- I agree
Internet Acceptable Use Policy Agreement*
- Student: I agree
- Parent: I agree
1. Students must have a signed AUP agreement on file before using the Internet at school. 2. Parents must sign the AUP agreement to indicate parental permission for student’s use of the Internet at school. 3. Students with signed agreements may use the Internet in the classroom only under the supervision of a school staff member. We have read, understand, and agree to abide by Eman Schools’ Acceptable Use Policy and guidelines. Please ask the school office if you want a copy of the agreement.

Emergency Contact Name 1*
First Last
Person to contact in an emergency if Parent/Guardian not available:
Phone # of Emergency Contact 1*
Emergency Contact Name 2
First Last
Person to contact in an emergency if Parent/Guardian not available:
Phone # of Emergency Contact 2
Primary Physician Name
First Last
Phone # of Primary Physician
Date of last physical:
Dentist Name
First Last
Phone # of Dentist
Date of last dental check up:
In the event of an emergency, your child will be taken to the nearest hospital for treatment. Please indicate if you have a preference of the hospital:
Please choose:*
- Select All
- I give Emergency Personnel permission to transport my child to an Emergency Room for treatment in my absence.
- I grant my permission for the staff at the Emergency Room to treat my child.
- I grant permission for the school to release all medical information that they have to the Emergency Room Personnel.

Students Records*
Eman Schools considers the records of all individual students to be confidential information. Student records will be released ONLY to other schools or agencies upon receipt of all outstanding fees, dues, and tuition accounts have been paid in full.
- I agree
Please upload a copy of student's Birth Certificate:
Max. file size: 256 MB.
Please upload the student's Birth Certificate here or email to accounting@emanschool.net. Your application will be not be considered complete until Eman Schools receive this file.
Please upload a copy of student's Immunization:
Max. file size: 256 MB.
Please upload the student's Immunization here or email to accounting@emanschool.net. Your application will be not be considered complete until Eman Schools receive this file.
Please sign Father's Name:*

By clicking on SUBMIT button, I verify that I have provided all the information to the best of my knowledge.
Please sign Mother's Name:*

By clicking on SUBMIT button, I verify that I have provided all the information to the best of my knowledge.
Today's Date*
MM slash DD slash YYYY
Visit our Pre-K page

https://www.emanschool.net/school/pre-school/

Eman Schools - New Student Information

Step 1 of 6 - Student Information