Enroll Date Campus Shots BC SSN HLS Par/Guar DL P O R Enrolled By Legal Doc TREx FAX Today's Date
What other Texas school districts has your child ever attended? _______________________________________________________________
STUDENT INFORMATION:
Grade Social Security Number
White Black Asian Am Indian Pacific Islander Bil/ESL GT Special Ed 504 Dyslexia Other (Specify)
Yes No
*Student Under CPS/Foster Care: Y NIf yes, is student currently served in DFPS? Y N If student is PK, was he/she previously in DFPS? Y N*Is the student an Unaccompanied Youth? Y If yes, is he/she receiving McKinney‐Vento services? Y N*I authorize Big Spring ISD to request school records for my student. (Initial consent)
( )
Receive
Living with
studen
t?
Work Phone
(Including Area Code)
Y N
Y N
Y N
Y N
If No, Address:
If No, Address:
If No, Address:
Emergency
Paren
t Guardian
If No, Address:
M FDate of Birth
(MM/DD/YYYY) / /
Birthplace (city,
state)
Hispanic
Ethnicity
Your Date of Birth
First Name Last Name
Mailing Address
List All BSISD students and grade:
Relationship to
Student
For Office Use Only
Big Spring ISD
Has this student ever attended Big Spring ISD before? Y
Most recent school attended before enrolling here: ___________________________________________________________________________________________________
Campus: ______________________
Student ID
If yes, when? ________________________
City, State, ZipSchool Name Phone (incl Area Code)
FAMILY INFORMATION:Primary Phone #
(incl. Area Code)
Race (check all that apply) Special Programs
Students Middle Student First Name Student Last Name
Sex
(circle one)
Cell Phone
(Including Area Code)
Physical Address
Presenting a false record or falsifying records is an offense under Section 37.10, Penal Code, and enrollment of the child under false documents
subjects the person to liability for tuition or other costs.
Drivers License # & State Todays DateSignature of Parent/Guardian
LPAC Framework Manual 2018-2019 240 Texas Education Agency
BIG SPRING INDEPENDENT SCHOOL DISTRICT
HOME LANGUAGE SURVEY-19 TAC Chapter 89, Subchapter BB, §89.1215
(Home Language Survey applicable ONLY if administered for students enrolling in pre-kindergarten through grade 12)
TO BE COMPLETED BY PARENT OR GUARDIAN FOR STUDENTS ENROLLING IN PREKINDERGARTEN THROUGH GRADE 8 (OR BY STUDENT IN GRADES 9-12): The state of Texas requires that the following information be completed for each student who enrolls in a Texas public school for the first time. It is the responsibility of the parent or guardian, not the school, to provide the language information requested by the questions below.
NAME OF STUDENT: ______________________________ STUDENT ID#: _______________________________
ADDRESS: _______________________________________ TELEPHONE #: _______________________________ CAMPUS: ________________________________________
NOTE: PLEASE INDICATE ONLY ONE LANGUAGE PER RESPONSE.
1. What language is spoken in the child’s home most of the time? ________________________ 2. What language does the child speak most of the time? ________________________
_______________________________________ ________________________________ Signature of Parent/Guardian Date
_______________________________________ ________________________________ Signature of Student if Grades 9-12 Date NOTE: If you believe you made an error when completing this Home Language Survey, you may request a correction, in writing, only if: 1) your child has not yet been assessed for English proficiency; and 2) your written correction request is made within two calendar weeks of your child’s enrollment date.
Dear Parent or Guardian:
To determine if your child would benefit from Bilingual and/or English as a Second Language program services, please answer the two questions below.
If either of your responses indicates the use of a language other than English, then the school district must conduct an assessment to determine how well your child communicates in English. This assessment information will be used to determine if Bilingual and/or English as a Second Language program services are appropriate and to inform instructional and program placement recommendations. If you have questions about the purpose and use of the Home Language Survey, or you would like assistance in completing the form, please contact your school/district personnel. For more information on the process that must be followed, please visit the following website: https://projects.esc20.net/upload/page/0084/docs/EL%20Identification_ReclassificationFlowchart%202018.pdf
This survey shall be kept in each student’s permanent record folder.
Big Spring Independent School District Records & Registration 1109 South Benton St
Big Spring, Texas 79720
DISTRIBUTION OF STUDENT INFORMATION
ALL information on BSISD students will be disseminated through the Records & Registration office.
Anyone requesting personal or educational information on a student needs to submit the request to the
R&R office.
“Directory Information” (as defined by the Texas Education Code and the BSISD School Board) will be
given out to the requesting party with legitimate interest in needing the information at the Records &
Registration office, in person, only if the enrolling legal parent or guardian has given written permission
for the release.
BSISD Directory information is considered:
Name
Address
Telephone Listing
Photograph
Grade Level
Enrollment Status
Homeroom Teacher
Participation in officially recognized activities and sports
Written consent will be kept and maintained at the Records and Registration office with the students
Enrollment information.
Unless indicated by a “mark out” of the particular information listed above, Directory Information for my child will be released.
Student Name: _______________________________________________ Grade: ____________ Campus: _______________________________
_________________________________ _____________________________________________________
Printed Name of Legal Parent or Guardian Signature of Legal Parent or Guardian
_________________
__________________________________________ Date Phone Number
Big Spring Independent School District STUDENT QUESTIONNAIRE 2019, 2020Campus Name: ____________ _
Legal Name of Student: ________________________ _
Date of Birth: ________ _ Age: Local ID#: ----------- -----
Parent/Guardian's Name ------------------------
Home Address ___________ City ------� TX Zip ___ _
Home Phone _( ___ }. _________ Cell Phone _(. ___________ _
Instructions: Indicate a true statement with a check mark.
Military (indicate the military qualifier that applies to your student): □Student is a dependent of an active duty member of the United States military
□Student is a dependent of a current member of the Texas National Guard (Army, Air Guard, or State Guard)□Student is a dependent of a current member of a reserve force in the United States military□Student is a dependent of a former member of the US military, Texas National Guard, or a reserve force in the US military□Student was a dependent of a member of a military or reserve force in the US military who was killed in the line ofduty.
(Acceptable documentation: Dept of Defense photo ID for active duty service members, a statement of service, copy of Purple Heart citation, line of duty determination or commander's letter.) Note: Do not make a copy of DoD identification.
McKinney Vento as defined by 42 U.S.C. Section 11302 (indicate the qualifier/s that are true): □Student temporarily lives with another family due to economic hardship□Student does not have a "fixed, regular, and adequate nighttime residence"□Student lives in a hotel or motel due to losing his or her housing□Student lives in a shelter
If yes to any of the above, choose appropriate status below:
□Student is in the physical custody of a parent or legal guardian□Student is NOT in the physical custody of a parent or legal guardian
Foster Care
□Student is in the custody of DFPS.Must provide verification letter from DFPS
Please read the following. Sign and date the application. I understand that school officials will verify the information on this application.
Parent/Guardian Signature Date
Office Use Only: Admin review: Date: _____ _
PRINTED NAME SIGNATURE
, Enrollment Date:
BIG SPRING INDEPENDENT SCHOOL DISTRICT 708 E 11th Place, Big Spring, TX 79720
(432) 264-3600
BIG SPRING HIGH SCHOOL WASHINGTON ELEMENTARY (9-12th GR) (3rd GR) 707 E 11TH Place 1201 S Birdwell Lane 432-264-3641 432-264-4126
ANDERSON ACCELERATED H S MARCY ELEMENTARY 229 Airbase Road (K-2nd GR) 432-264-4115 2101 Wasson Drive 432-264-4144
BIG SPRING JUNIOR HIGH MOSS ELEMENTARY (7-8th GR) (K-2nd GR) 624 E 6TH Street 3200 Fordham 432-264-4135 432-264-4148
BIG SPRING INTERMEDIATE KENTWOOD EARLY (5-6th GR) CHILDHOOD CENTER 2000 S Goliad St 2500 Merrily 432-264-4121 432-264-4130
GOLIAD ELEMENTARY BUS BARN (4TH GR) 432-264-4108 1801 S Goliad St 432-264-4111
FOOD SERVICE 432-264-3635
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