Required Documents
For Registration
Registration Hours: 7:00am-2:00pm
Tel: (671) 642-2100
NOTE: Students Should Be Registered By Birth Parents or Legal
Guardians with Court Documents
 Student (s) & Parent(s)/Guardian(s) must be present when enrolling (Proof of
Guardianship)
 Proof of Residency: *Mayor’s Verification (Name(s) of parents/legal guardian(s) and
children), *Copy of Mortgage Settlement Sheet/Deed to Property/Rental Lease
Agreement Clearly Showing the Complete Home Address, *Utility Bill (Power, Water,
Telephone, etc.)
 Official Birth Certificate
 Parent(s)/Guardian(s) Valid Photo Identification & Copy of Drivers License
 Last Report Card/ Official Transcript/Official Withdrawal Form from previous
school (Requested).
 Students Attendance and Discipline Profile
 If appropriate: Most Recent IEP, or Agency Letter of Placement
 Immunization Record (TB skin test required, as per BOARD POLICY (BP 337)
*TB skin test conducted within a year prior to registration if the child is entering from the
U.S.A. or a U.S. Territory.
*TB skin test conducted within six (6) months prior to registration if the child is entering from
a non-U.S. Territory.
 Physical Examination (incoming from off-island required as per BP 337; pending
appointment card accepted)
*Results of A Physical Examination Conducted Within One (1) Year Prior To or After Entry into
Any School System.
*Or official Documentation which shows that a physical exam has been scheduled for the
child.
Revised Date: 1/25/2013
REGISTRATION CHECKLIST
Student’s Name: ________________________________
Date of Birth: _____________________
Initials
Verification
1. Accompanied by a parent(s)/legal guardian(s) (under 18 years of age)
2. Completed district registration forms
3. Proof of Residency: Mayor’s Verification, Mortgage Settlement
Sheet/Rental Lease Agreement, and Utility Bill ((Power, Water,
Telephone, etc.)
4. Official Birth Certificate
5. Parent (s)/Guardian(s) Current Photo Identification
6. Last Report Card/Official Transcript/Official Withdrawal Form From
Previous School (Requested) *circle document provided
7. Immunization Record
8. Physical Examination (or an appointment card)
9. Students attendance and discipline profile
_______________________
_______________________
Ms. Michelle Palacios / Date
Counseling Clerk
Dr. Kelly Sukola / Date
Assistant Principal Curriculum & Instruction
NURSE ‘S OFFICE
1. Immunization Records up-to-date and a copy made
2. Notice of Required Immunization and date issued
3. Health Information and Emergency card completed
ASST. PRINCIPAL –
CURRICULUM
_____
Recommended
_____
Not
Recommended
ASST. PRINCIPAL –
STUDENT SUPPORT
SERVICES
_____
Accepted
_____
Not Accepted
_________________________
Mrs. Elizabeth T. Hanzsek / Date
Assistant Principal Student Support Services
Nurse’s Signature: ___________________________________
Date: ______________
COUNSELOR’S OFFICE
1. Student Number Assigned: _______________________
2. Birth Certificate
3. Guardianship or other legal documents
4. Proof of Residency
5. Notice of Eligibility of Special Education (SPED) services; if applicable
6. Placement test administered; as needed
7. “Language Assessment” Form complete;
8. Foreign Student documents
9. Graduation Requirements explained; (Student Achievement Guide)
10. Official Transcript or Curricular Records; signed record request form
Counselor’s Signature: _______________________________
Revised Date: 1/25/2013
Date: _____________
JOHN F. KENNEDY HIGH SCHOOL
331 North Marine Corps Dr.
Tamuning, Guam 96913
(671) 642-2100
DATE
R2
R3
R4
R5
/
/
FROM ANOTHER PUBLIC SCHOOL ON GUAM
R6
FROM THE SAME GUAM PUBLIC SCHOOL AFTER WITHDRAWAL
FROM A NON-PUBLIC SCHOOL ON GUAM
R7
FROM GCC
FROM A SCHOOL OFF-ISLAND
R8
DYA
FROM ANOTHER GUAM PUBLIC SCHOOL AFTER WITHDRAWAL OR EXPLULSION
STUDENT ID:_______________STUDENTNAME:___________________________________________________________
LAST,
FIRST
MI.
GRADE: ________SEX: (M) OR (F) ________ DATE OF BIRTH:_____________ PLACE OF BIRTH:____________________
How many years in high school? (Circle one):
1
2
3
4
5
6
HOME ADDRESS: ___________________________________________________________________________________
HOUSE NO.
STREET NAME
VILLAGE
MAILING ADDRESS:__________________________________________________________________________________
HOUSE NO/ P.O.BOX
STREET NAME/CITY
VILLAGE/STATE
ZIP CODE
---------------------------------------------------------------------------------------------------------------------------------------------------------------SCHOOL DISTRICT: PLEASE CIRCLE WHERE YOU LIVE
K10 ADELUP
K16 ANIGUA
25 ASARTAS
K19 ASTUMBO -SAN LINAHYAN/LOWER
WE36 CALLE J.L. BLAS ST.
WE60 CARMENCITA WAY
K22 CARLOS HEIGHTS
MU41 CATALINA COURT
MU39 CATALINA STREET.
K25 DEDEDO
HMU19 EAST KAISER
WE63 EAST SALISBURY
WE35 GHURA 35 – DEDEDO
WE33 GHURA 48
K34 GHURA 501 – INCLUDES BATULO ST.
WE42 GLORIA CIRCLE
K43 GUAM HORIZON
WE48 GUAM RENTAL CORP LADA GARDENS
K46 GUAM TOWERS
K13 HAGATNA
K49 HARMON
HL19 HARMON CT./GARDEN
CP16 HIGHWAY CHURCH
U13 HOTEL MAIANA
JT16 JONESTOWN
KS52 LIGUAN TERRACE - NEAR WETTENGEL & PIPELINE
ATES CT./SOUTH OKUDO, CALEMENDO LOOP , ETC.
K67 TAMUNING
K70 TUMON
JT24 TUMON HEIGHTS
D19 TUMON VILLAGE
WE39 WEST KAISER
WE49 WEST SAN ANTONIO
WE69 WEST SANTA BARBARA ST.
WE66 WEST SANTA MONICA ST.
MU13 Y-SENGSONG
F24 Y-SENGSONG – CHN. PALAUAN
C&HFARM,NEVERMIND RD.STAMPA
K55 MACHANAO – PIGA & IRONWOOD , ETC.
WK31 MAINA
WE54 ROSITA LANE
HL21 SUNRISE VILLA/BANYAN HEIGHTS
OUT OF DISTRICT: REQUIRES ADMINISTRATOR’S APPROVAL (PLEASE CIRCLE WHERE YOU LIVE)
S10 AGAFA GUAMAS
W10 AGANA HEIGHTS
W13 AGANA SPRINGS
V10 AGAT
S15 ANDERSEN
S20 ANDERSEN SOUTH
V13 APRA HEITHTS
WV22 ASAN
W19 BARRIGADA
W16 BARRIGADA HEIGHTS
N10 BAZA GARDENS
W22 CHALAN PAGO
K40 GHURA 503
S30 GHURA 505
S35 GHURA 506
N15 INARAJAN
N20 IPAN
W25 LATTE HEITHTS
S65 MACHANANAO
WS28 MACHECHE
W34 MAITE
N25 MALOJLOJ
N30 MERIZO
S45 MOGFOG
W40 MONGMONG
W46 NAVAL HOSPITAL
V25 NAVAL STATION
K58 NCTAMS
W49 NCS BARRIGADA
K61 NCS DEDEDO
NV40 UMATAC
V16 NEW APRA
V28 NIMITZ HILLS
V19 OLD APRA
W52 ORDOT
V37 PAGACHAO
S50 PEREZ ACRES
V31 PITI
V34 SANTA RITA
W55 SINAJANA
N35 TALOFOFO
W58 TOTO
NV40 UMATAC
WN45 WINDWARD HILLS
MU27 WUSSTIG
S55 YIGO
WN50 YONA
S60 YPAOPAO ESTATES
RESIDES WITH (CIRCLE ONE)
F
M
P
G
RELATIONSHIP
FATHER ONLY
GM
MOTHER ONLY
GF
PARENTS
GP
GUARDIAN
O
NAME OF PERSON(S) STUDENT RESIDES WITH:
GRANDMOTHER
GRANDFATHER
________________________________________________________
GRANDPARENTS
OTHER: (NOTE RELATIONSHIP) _________________________
---------------------------------------------------------------------------------------------------------------------------------------------------------------CIRCLE ALL PERVIOUS HIGH SCHOOLS ATTENDED
GEORGE WASHINGTON H.S.
JOHN F. KENNEDY H.S.
OKKODO HIGH
SIMON A. SANCHEZ H.S.
SOUTHERN H.S.
ASMUYAO COMMUNITY S.
GUAM COMMUNITY COLLEGE
GUAM HIGH SCHOOL (DOD)
AGUEDA I. JOHNSTON M.S.
ASTUMBO M.S.
FRANCISCO B. LEON GUERRERO M.S.
JOSE LG. RIOS M.S.
LUIS P. UNTALAN M.S.
OCEANVIEW M.S.
ACADEMY OF OUR LADY
FATHER DUENAS
GUAM EVANGELICAL CHRISTIAN ACADEMY
GUAM ADVENTIST ACADEMY
HARVEST CHRISTIAN ACADEMY
NOTRE DAME H.S
SAINT JOHN’S
SAINT PAUL
SAINT THOMAS
ST. ANTHONY
MT. CARMEL
BISHOP BAUMGARTNER
SAN VICENTE
SANTA BARBARA
BELAU
CHUUK
FOREIGN SCHOOL
HOME STUDY
KOSRAE
MAIN LAND
MARSHALLS
PHILIPPINES
POHNPEI
ROTA
SAIPAN
TINIAN
YAP
IN NOT SHOWN PLEASE LIST ALL SCHOOLS ATTENDED: _________________________________________________________
-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------ETHNIC BACKGROUND (NEEDED FOR STATISTICAL PURPOSES – CIRCLE ONE)
A
AR
AS
AT
B
C
D
CHAMORRO
ROTA
SAIPAN
TINIAN
FILIPINO
WHITE (NOT HISPANIC)
AFRICAN AMERICAN
E JAPANESE
F CHINESE
G KOREAN
H HAWAIIAN
I SAMOAN
J KOSRAEAN
K POHNPEIAN
L CHUUKESE
S INDONESIAN
M YAPESE
T OTHER PACIFIC ISLANDER (FIJIAN)
N MARSHALLESE
U OTHERS (MIXED)
O BELAUAN
P VIETNAMESE
Q HISPANIC
R AMERICAN INDIAN / ALASKAN NATIVE
--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
FEDERAL STATUS (CIRCLE ONE)
A
B
C
D
E
NAVY (MILITARY)
NAVY (CIVILIAN)
AIR FORCE (MILITARY)
AIR FORCE (CIVILIAN)
ARMY (MILITARY)
F
G
H
I
J
ARMY (CIVILIAN)
COAST GUARD (MILITARY)
COAST GUARD (CIVILIAN)
MARINE CORPS (MILITARY)
MARINE CORPS (CIVILIAN)
K OTHER FEDERAL AGENCIES
L STUDENT I-20
M ALL OTHERS
N RESERVES (INACTIVE/PART-TIME)
O NATIONAL GUARD (INATIVE/PARTTIME
P RETIRED MILITARY
Q ACTIVE RESERVES/NATIONAL GUARD
-------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------
LIVING STATUS (CIRCLE ONE)
1
LIVE & WORK ON FEDERAL PROPERTY
3
LIVE ON FEDERAL PROPERTY (LOW COST HOUSING)
2
WORK ON FEDERAL PROPERTY
4
NON-FEDERALLY CONNECTED
ALIEN STATUS (CIRCLE ONE)
1 US CITIZEN
5
FSM CITIZEN
2 CNMI CITIZEN
6
MARSHALLESE CITIZEN
3 PERMANENT RESIDENT ALIEN (GREEN CARD)
7
BELAUAN CITIZEN
4 1-20/FOREIGN STUDENT/F – VISA
---------------------------------------------------------------------------------------------------------------------------------------------------------------PARENT/GUARDIAN INFORMATION
FATHER OR GUARDIAN’S NAME:
MOTHER OR GUARDIAN’S NAME
_____________________________________
_________________________________________
LAST, FIRST MI.
LAST, FIRST MI.
PLACE OF EMPLOYMENT:
PLACE OF EMPLOYMENT:
WORK TELEPHONE NUMBER:
WORK TELEPHONE NUMBER:
HOME TELEPHONE NO. / MOBILE PHONE
HOME TELEPHONE NO. / MOBILE PHONE
/
EMAIL ADDRESS
/
EMAIL ADDRESS
IN CASE OF EMERGENCY PLEASE CONTACT: (NOT ABLE TO CONTACT PARENT(S)/GUARDIAN(S)
1. Please contact:
Address:
Relationship
Telephone #
.
.
2. Please contact:
Address:
Relationship:
Telephone #
.
.
*At anytime that a change of residence should occur; the school shall be notified. Failure to do so will result in the student’s immediate disenrollment from JFKHS.
If any of the information is found to be false, fraudulent, or inaccurate, the parent will be promptly notified
and the student shall be immediately disenrolled and sent to his/her respective school attendance area.
PRINT NAME:
SIGNATURE
DATE:
PLACEMENT & POLICIES INFORMATION FORM
I.
SERVICES RECEIVED
Please circle services your child is receiving or has received:
SPED
ESL
504
None
FREE/REDUCED MEALS
II.
LEARNING PATH (Please circle one):
Students, with the assistance of parents, need to select the PATH they will follow in high school.
A. COLLEGE (CP)
B. CAREER (VP) (If career is selected, please choose a course of study below)
Business/Computers
Allied Health (Nursing)
Fine Arts
Carpentry
HPERD
Electronics and Computer Networking
Consumer Family Science
Tourism (Pro Start or Lodging)
JROTC
Automotive (Automotive I & II)
Marketing
I.
BOARD POLICIES
Board Policy 330: Part III: Length of Attendance. “High School students shall be given six (6)
continuous years to complete their graduation requirements, commencing from their first day in 9th
grade.”
Board Policy 330: Part IV: Removal of students of Non Compulsory Age. (16+ years) “A student of
non-compulsory attendance age who has accumulated a total of twenty-five (25) days of absence
may be dropped from school for the balance of academic year…” If a student of non-compulsory
attendance age fails all classes, despite intervention attempts by the school the student may be
dropped for the remainder of the semester.”
Board Policy 411: Attendance and Grading. “A student will receive no credit grade for that course
after accumulating 6 unexcused absences for that semester. Three (3) unexcused tardies equal one
unexcused absence for that semester, and students who are ten (10) or more minutes tardy for a
class shall be considered as absent from the class.”
_____________________________________
Parent’s /Guardian’s Signature
____________________
Date
_____________________________________
Student’s Signature
____________________
Date
GOVERNMENT OF GUAM
JOHN F. KENNEDY HIGH SCHOOL
DEPARTMENT OF EDUCATION
Jon J. P. Fernandez
Superintendent of Education
Dr. Barbara Adamos
School Principal
UNAVAILABLE SCHOOL RECORDS
Date:
__________________________________________
Regarding Student:
__________________________________________
We, the undersigned, understand that because no official school curriculum records were provided to JFKHS at
this time, my child will be registered based on the information provided.
Should, after the official school curriculum records arrive, it be found that placement was incorrect; my child
will be placed in the correct program at the beginning of the semester, if possible.
However, it is further understood that because official records often do not arrive in a timely manner, loss of
credit may occur.
_______________________________________
Parent/Guardian’s Signature
_________________________________
Date
LIST SUBJECTS/COURSES YOU HAVE TAKEN IN HIGH SCHOOL:
COURSES
SCHOOL YEAR: _________
SEMESTER TAKEN
1ST /2ND
_______________________________________
Student’s Signature
Revised Date: 1/25/2013
COURSES
SCHOOL YEAR: _________
SEMESTER TAKEN
1ST /2ND
_________________________________
Date
GOVERNMENT OF GUAM
JOHN F. KENNEDY HIGH SCHOOL
DEPARTMENT OF EDUCATION
Jon J. P.Fernandez
Superintendent of Education
Dr. Barbara Adamos
School Principal
RECORDS REQUEST FORM
Date: _________________________________
Previous School Address
___________________________________________
___________________________________________
___________________________________________
To Whom It May Concern:
_______________________________________________, Date of Birth, ________________________, Grade __________________ has
enrolled at JOHN F. KENNEDY HIGH SCHOOL.
Please send the cumulative folder, official transcript, health records, and withdrawal grades for the above
student. Should you have any other pertinent records (e.g. psychological examinations), we would
appreciate this also.
If you do not have this student’s records, please notify us so that we can attempt to locate them
elsewhere.
Thank you for your cooperation.
Sincerely,
Barbara Adamos, Ed. D.
Principal
Contact Person: __________________________________________
Permission is granted to release the records of my son/daughter.
____________________________________________
(PARENT OR GUARDIAN’S SIGNATURE)
FEDERAL LAW 99.31, 1-78: NO PARENT SIGNATURE IS REQUIRED FOR EDUCATIONAL RECORDS TO BE SENT TO ANOTHER EDUCATIONALSCHOOL/
FAMILY EDUCATIONAL RIGHTS AND PRIVACY ACT OF 1974
Revised Date: 1/25/2013