DEARBORN HEIGHTS SCHOOL DISTRICT NO. 7
BOARD OF EDUCATION
Dear Parents:
The items listed below are mandatory to enroll your child(ren) in our school system. You must
have these documents present at the time of enrollment.

Original Birth Certificate

Immunization Record

Utility Bill (and)

Mortgage Statement, Tax Bill or Rental Agreement ( if you own your home)

Rental Agreement ( if renting a home)

Report Card or transcript (Middle or High School)

Proof of Custody (divorce or guardianship paperwork)

IEP paperwork, if your child receives Special Education Services of any kind including
speech services.

Name and address of last school attended
All other required documents will be provided by the Board of Education at the time of
enrollment. Questions? Call (313) 278-1900 Ext. 234
The Resident Enrollment Form for 2006/2007 School Year is below on the next
page
RESIDENT STUDENT ENROLLMENT FORM
____________________
Student’s Last Name
_______________
First Name
_________________________________
Street Address
_____
M.I.
_____
Sex
_____
Race
____________________
City
___/__/___
Birth date
__________
Zip Code
______________
Grade Entering
__________________
Birth City
Circle one choice for the female head-of-household and male head-of –household
Mother
Stepmother
Grandmother________________________________________
Fiancée
Last Name
First Name
Friend
Father
Stepfather
Grandfather _________________________________________
Fiancée
Last Name
First Name
Friend
Phone Number______________________________________________________________________________
Home #
Cell #
Work #
Non-custodial Parent Information: (optional) ________________________________________________
Last Name
First Name
________________________
Street Address
_____
Apt.
_____________________
City
_______________
State
____________
Zip Code
School District last attended:_________________ Name of school last attended:_________________
Has the student ever been retained in a grade? ________________ If yes, what grade? _________
Does your child need to take medication during school hours?………………………………_________
Describe any chronic health problems:________________________________________________________
Did your child receive Special Education services during the past school year?…………. ________
If yes, a current IEP must be provided by the parent.
Do you have custody paperwork, such as divorce or guardianship papers? … . ……… _________
Is the student’s first learned language English? _______yes _______no
If the above answer is no, what is the student’s first learned language?_________________________
Other school age children in the family:
Last Name
First Name
Birth date
Grade
School
_____________________
______________________
___/___/___ _______
_____________________
_____________________
______________________
___/___/___ _______
_____________________
_____________________
______________________
___/___/___ _______
_____________________
FOR OFFICE USE ONLY
DEARBORN HEIGHTS SCHOOL DISTRICT NO. 7 REQUIRED RESIDENCY DOCUMENTATION:
_____Utility Bill
and
_____Mortgage or Property Tax Bill
or
_____Lease Agreement
or
_____Residency Affidavit
REQUIRED STUDENT DOCUMENTATION:
_____Birth Certificate
_____Immunization Record
_____Record Request
_____Transcript or Report Card (High School Students Only)
_____Custody Papers (If applicable)
_____Current IEP (Special Education Requirement)
filed: enrollment form
revised 03/15/06 /dw
Building Assignment:___________________________
Date of Enrollment:_____________________________
Enrolled By:____________________________________