IMPORTANT
Registration and Residency Information
Registration
In order to register and attend the Newton Public Schools, a student must actually reside in the City
of Newton with a parent/legal guardian. “Residency” is defined as the place where a person has
his/her permanent home, i.e., “the place where a person dwells and which is the center of his
domestic, social and civil life.”[1] For minor children, the legal residency is presumed to be the legal
residence of the parent(s) or legal guardian(s) who has physical custody of the minor child.
Students who are visiting Newton are not eligible to attend the Newton Public Schools.
Please read below and provide documents as indicated:
1.
2.
3.
4.
Proof of Age (Original Birth Certificate or Passport)
Proof of Immunization (Medical/Health Record)
NPS Registration Form
Proof of Residency (See below)
Residency Requirements
The Newton Public Schools reserves the right to request proof of residency when students are
initially enrolled. The types of documents requested as proof of residency are stated below. Newton
Public Schools also reserves the right to verify residency either at the time of enrollment or during
the academic school year. Since family situations can change, the Newton Public Schools reserves
the right to request additional, updated information when warranted.
The Assistant Superintendent may initiate an investigation in conjunction with the Youth Officer,
including a home visit to verify residency. If a student is found not to be primarily residing in the
City of Newton, the student will need to enroll in the school district of the city/town where he/she
actually resides. Factors that may trigger an investigation include, but are not limited to, the
following: changes in residency not reported immediately to the school where the student is
enrolled; mail returned to the school; incomplete or contradictory proofs of residency; or
anonymous calls reporting suspected residency violations.
Families found to be in violation of these guidelines will face strict penalties, including, but not
limited to, immediate dismissal from school; per diem charges for the education and related
services accessed as a non-resident which are based on the per pupil cost to the district; and
possible legal action.
The following documents will be required as a proof of a physical address in Newton when new students
are registered.
P. O. Boxes will not be accepted with the exception of documented court related reasons.
New Home Owners
 Executed Purchase and Sales Agreement with closing date and mortgage statement. Registration
can take place within two weeks of closing/move-in date, AND
 Two utility bills (gas, oil, electric, telephone, cable) OR
current car insurance statement, Massachusetts car registration and excise tax bill.
Established Home Owners
 Mortgage statement AND
 Two utility bills (gas, oil, electric, telephone, cable) OR
current car insurance statement, Massachusetts car registration and excise tax bill.
Registration and Residency Information
Page Two
Renters
 A formal rental or lease agreement indicating the number and names of tenants. Dates of lease with
both landlord and tenant signatures is required. Registration can take place within two weeks of the
start of the lease/move-in date, AND
 Two utility bills (gas, oil, electric, telephone, cable) OR
current car insurance statement, Massachusetts car registration and excise tax bill.
*Notarized letters will not be accepted in lieu of a lease.
Tenant-at-Will
 Preregistration forms completed, notarized and returned to Education Center, Room 218, 100 Walnut
Street, Newton. Home visit to follow.
 Two utility bills (gas, oil, electric, telephone, cable) OR
current car insurance statement, Massachusetts car registration and excise tax bill.
*Notarized letters will not be accepted in lieu of a lease.
Family/Student over 18 in Residence with Friends/Family
 Pre-registration form(s) completed, notarized and returned to Education Center, Room 218,
100 Walnut Street, Newton. Home visit to follow.
Student (under age 18) Living in Newton with Legal Guardian/Other
Students living in Newton without a parent should contact 617-559-6105 to schedule a time
to come to the Education Center to determine registration eligibility. Documentation of a
completed and notarized Caregiver Affidavit or court documents indicating legal
guardianship must be presented at that time. A review of the documents will be conducted
to determine if the student is eligible to attend school in Newton. In certain circumstances,
students who are living with an adult who is not their parent may be charged tuition.
Nanny/Housekeeper Living in Employer’s Home
 Pre-registration forms completed, notarized and returned to Education Center, Room 218,
100 Walnut Street, Newton. Home visit to follow.
Joint Physical Custody
 In cases of separation or divorce, physical custody agreements must be presented to the
district school. Documentation must establish that Newton is the primary residence of the
student.
1
See Teel v. Hamilton-Wenham Regional School District, 13 Mass. App. Ct. 345, 348 (1982)
NPS rev. 2016
NEWTON PUBLIC SCHOOLS REGISTRATION FORM
Date
FULL LEGAL NAME AS IT APPEARS ON LEGAL DOCUMENTS
Student
Last Name
First Name
STUDENT’S PERSONAL INFORMATION
Date of Birth (mm/dd/yyyy)
Grade Level at Registration
Birthplace:
City
State
 Sibling of Enrolled Student
Middle Name
Gender
 Male
Country
 Former Newton Student
OTHER SCHOOL AGE CHILDREN
Child’s Name
School Name/Location
PREVIOUS SCHOOL ATTENDANCE
School Name
 Female
Grade
DOB
Dates of Attendance (mm/yyyy- mm/yyyy)
School Address
Grade Level(s) Attended
School Phone Number
Public School
Other
School Name
Dates of Attendance (mm/yyyy- mm/yyyy)
School Address
Grade Level(s) Attended
School Phone Number
Public School
Private School
Other____________________________________
School Name
Dates of Attendance (mm/yyyy- mm/yyyy)
School Address
Grade Level(s) Attended
School Phone Number
Public School
Other
Preschool Attendance
 Yes
 No
Name and Location
Private School
Private School
Attendance Dates
ETHNICITY/RACE INFORMATION
The collection of this information is authorized by State and Federal law. When the parent/legal guardian does not provide
the ethnicity/race of the student, the school is required to make a determination.
ETHNICITY (check only one):
RACE (check one or more)
 American Indian or Alaska Native
 Asian
 Black or African America
 Native Hawaiian or Other Pacific Islander
 White
 Hispanic or Latino
 Not Hispanic or Latino
Home Language Survey
Massachusetts Department of Elementary and Secondary Education regulations require that all schools determine the
language(s) spoken in each student’s home in order to identify their specific language needs. This information is essential in
order for schools to provide meaningful instruction for all students. If a language other than English is spoken in the home,
the District is required to do further assessment of your child. Please help us meet this important requirement by answering
the following questions. Thank you for your assistance.
Student Information
Country of Birth
/
/
Date of Birth (mm/dd/yyyy )
/
/
Date first enrolled in ANY U.S. school
(mm/dd/yyyy)
School Information
Start Date in New School (mm/dd/yyyy)
Name of Former School and Town
Current Grade
Questions for Parent(s)/Legal Guardian(s)
What is the native language(s) of each
parent/guardian?
Which language(s) are spoken with your child?
Circle one: mother / father /legal guardian
Circle one: seldom / sometimes / often / always
Circle one: mother / father / legal guardian
Circle one: seldom / sometimes / often / always
What language did your child first understand and
speak?
Which language do you use most with your child?
Which other languages does your child know?
Which languages does your child use?
Circle all that apply: speak / read / write
Circle one: seldom / sometimes / often / always
Circle all that apply: speak / read / write
Circle one: seldom / sometimes / often / always
Will you require written information from
school in your native language? Yes  No 
Parent/Guardian Signature:
(include relatives -grandparents, uncles, aunts, etc. - and caregivers)
Will you require an interpreter/translator at ParentTeacher meetings? Yes  No 
Today’s Date (mm/dd/yyyy)
OFFICE USE ONLY:
Enrolled in ELL:  Yes  No
ELL Staff Initials________________
If not enrolled in ELL, check below:
 Student is English Proficient
 Student is Limited English Proficient, but parent/legal guardian refused services
Newton Public Schools Registration Form
Page 2
PARENT/LEGAL GUARDIAN CONTACT INFORMATION – PRIMARY
Parent/Legal Guardian Name
Circle:
Mr./Mrs./Ms./Dr.
Last Name
Relationship to child:
 Mother  Father
 Other*
First Name
Divorced or Separated?  Yes  No
*If other, please provide proof of legal
guardianship.
*Please provide documentation of physical custody.
If yes*,  Sole Custody  Joint Custody
Phone/Email Contact Information
Phone
Type (Choose
Phone number
Phone 2
Phone3
Cell
Work
Cell
Work
Cell
Work
Should receive mailings
for child?  Yes  No
Automated Contact System
Ext.
One)
Primary
Lives with child?
 Yes  No
Would you like to designate this number for
automated calling in cases of school closing and
emergency information?
Home
Other
Home
Other
Home
Other
 Yes
 No
 Yes
 No
 Yes
 No
Email address:
Physical Address
(P.O. boxes will not be accepted as a physical address with the exception of documented, court-related reasons.)
Street #
Street Name
Apt. #
City/Town
State
Zip Code
Mailing Address, if different
Street #
Street Name
Apt. #
City/Town
State
Zip Code
Language/Communication Information
Parent/Legal Guardian’s language of communication, if not English?
Is an interpreter required?
 Yes
Newton Public Schools Registration Form
 No
Requires translated materials?  Yes
 No
Page 3
PARENT/LEGAL GUARDIAN CONTACT INFORMATION – SECONDARY
Parent/Legal Guardian Name
Circle:
Mr./Mrs./Ms./Dr.
Last Name
Relationship to child:
 Mother  Father
 Other*
First Name
Divorced or Separated?  Yes  No
*If other, please provide proof of legal
guardianship.
*Please provide documentation of physical custody.
If yes*,  Sole Custody  Joint Custody
Phone/Email Contact Information
Phone
Type (Choose
Phone number
Phone 2
Phone3
Cell
Work
Cell
Work
Cell
Work
 Yes
 No
Should receive mailings
for child?  Yes  No
Automated Contact System
Ext.
One)
Primary
Lives with child?
Would you like to designate this number for
automated calling in cases of school closing and
emergency information?
Home
Other
Home
Other
Home
Other
 Yes
 No
 Yes
 No
 Yes
 No
Email address:
Physical Address
(P.O. boxes will not be accepted as a physical address with the exception of documented, court-related reasons.)
Street #
Street Name
Apt. #
City/Town
State
Zip Code
Mailing Address, if different
Street #
Street Name
Apt. #
City/Town
State
Zip Code
Language/Communication Information
Parent/Legal Guardian’s language of communication, if not English?
Is an interpreter required?
 Yes
Newton Public Schools Registration Form
 No
Requires translated materials?  Yes
 No
Page 4
EMERGENCY CONTACT - PRIMARY
Emergency Contact Name
Circle:
Mr./Mrs./Ms./Dr.
Last Name
Relationship to child:
First Name
Is this person authorized to pick-up/transport your
child in case of emergency?  Yes  No
Phone Contact Information
Phone
Primary
Phone 2
Phone3
Type (Choose One)
Cell
Work
Cell
Work
Cell
Work
Phone number
Ext.
Home
Other
Home
Other
Home
Other
EMERGENCY CONTACT - SECONDARY
Emergency Contact Name
Circle:
Mr./Mrs./Ms./Dr.
Last Name
Relationship to child:
First Name
Is this person authorized to pick-up/transport your
child in case of emergency?  Yes  No
Phone Contact Information
Phone
Primary
Phone 2
Phone3
Type (Choose One)
Cell
Work
Cell
Work
Cell
Work
Phone number
Ext.
Home
Other
Home
Other
Home
Other
Newton Public Schools Registration Form
Page 5
Permission Form to Release Student Record Information
PERMISSION TO RELEASE STUDENT INFORMATION TO PTOS, SCHOOL PHOTOGRAPHERS AND OTHER
THIRD PARTIES
Pursuant to the federal and state regulations governing student records, Newton Public Schools may release certain information concerning your
child/you to third parties without first obtaining your consent, unless you notify Newton Public Schools in writing that you do not want such
information to be released. "Third Parties" are defined in these regulations to be "… any person, private or public agency … or organization other than
the eligible student, his/her parent, or authorized school personnel." 603 CMR 23.02. For example, third parties to whom Newton Public
Schools may release student record information would include PTOs, school photographers, the Newton Schools
Foundation, NewTV and newspapers which report on student activities, etc.
The information that may be released is limited to the following: Student's name, ID number, address, telephone listing, date and place of birth, major
field of study, dates of attendance, weight and height of members of athletic teams, class, participation in officially recognized activities and sports,
degrees, honors and awards, and post-high school plans.
You will be asked to review this policy annually.
I give permission for information concerning my child/myself to be released to third parties.
I give permission for information to be released to school photographers so that student
pictures can be identified.
I give permission for information to be released to the PTO to be included in the school
directory.
 Yes
 Yes
 No
 No
 Yes
 No
Publishing of Student Photographs on School Websites
Properly organized and constructed web sites contain key information for students, staff, and parents, as well as the local and global communities. The
Web allows students not only to be users of up-to-the-minute data available but also be producers in an interactive dialogue in the online global
community. Publishing district, school, and classroom Web pages on the World Wide Web integrates many educational skills with electronic
technology – writing, editing, word-processing, desktop publishing, graphic design, and media literacy among others. As appropriate, the school
department approves of student pictures posted on the Web.
I give permission for a portrait, photograph or video production containing an image of my
child to be posted on the Newton Web Pages. A student's name will not be placed with the
student's picture unless the picture is being posted to give special recognition to that particular
student, i.e., as the recipient of an award or an actor in a play.
 Yes
 No
Student Teacher Filming in Classroom
Student teachers are often required to use a portrait, photograph or video production containing an image of your child.
This image will be used for internal college/university use only for student teacher evaluation purposes.
I give permission for a student teacher to use a portrait, photograph or video production
containing an image of my child.
 Yes
 No
FOR MIDDLE AND HIGH SCHOOL STUDENTS ONLY
OPT-OUT Form for Release of Student Record Information to Military Recruiters
Military Recruiters Access to Student Information under the "Every Student Succeeds Acts of 2015"
The "Every Student Succeeds Act of 2015" requires public schools receiving federal funds to provide the names, addresses and telephone
numbers of secondary school students upon a request made by military recruiters. The Act also provides that the parent/guardian of the
student or the secondary school student (if over 18 years of age) may request that the school not release this information without the prior written
consent of the parent/guardian or student. You will be asked to renew this request annually.

I DO NOT give consent to release student information on my child/me (if over 18 years of age) to military
recruiters.
Newton Public Schools Registration Form
Page 6
FOR MIDDLE AND HIGH SCHOOL STUDENTS ONLY
OPT-OUT Form for Release of Student Record Information to Institutions of Higher Education
Institutions of Higher Education Access to Student Information
Under the "Every Student Succeeds Act of 2015"
The "Every Student Succeeds Act of 2015" requires public schools receiving federal funds to provide the names, addresses and telephone
numbers of secondary school students upon a request made by institutions of higher education . The Act also provides that the
parent/guardian of the student or the secondary school student (if over 18 years of age) may request that the school not release this information
without the prior written consent of the parent/guardian or student. You will be asked to renew this request annually.

I DO NOT give consent to release student information on my child/me (if over 18 years of age) to institutions
of higher education.
Student’s Name
Signature of Parent/Legal Guardian or
Student (If over 18 years of age)
Date
OTHER STUDENT/FAMILY INFORMATION
Military Family
 Yes
Is the student part of a military family?
 No
Select “yes” if your student has a parent/legal Guardian who is:
1. An active duty member of the uniformed services or a National Guard and Reserve
member on active duty orders, or
2. A member or veteran who has been medically discharged or retired for 1 year, or
3. A member who passed away while on active duty.
IMMIGRANT DEMOGRAPHICS:
Was your child born in the 50 United States OR Puerto Rico, District of Columbia,
Guam, American Samoa, Virgin Islands, Northern Mariana Islands and Trust
Territory of the Pacific Islands?
Has your child completed 3 full academic years of school in any State or Territory
(see above)?
 Yes
 No
 Yes
 No
If the answer is NO to BOTH questions above, you must complete the following:
Child’s Country of Origin?
When did your child first enter
school (grades K-12) in the United
States?
Newton Public Schools Registration Form
MONTH:
DAY:
YEAR:
Page 7
State and federal law guarantees that no student’s record is available to person(s) outside the school without parental
consent or a court order.
LOW INCOME STATUS (OPTIONAL):
Please circle the applicable income level, if
appropriate (based on U.S. Federal poverty
guidelines for 2015-16):
Is the child eligible for free/reduced school lunch?
 Yes
 No
Is the child eligible for Transitional Aid to
Families?
 Yes
 No
Is the child eligible for Food Stamps?
 Yes
 No
Household
Size
Yearly
Income
Monthly
Income
Weekly
Income
1
2
3
4
5
6
7
8
Each additional
person:
$21,775
$29,471
$37,167
$44,863
$52,559
$60,255
$67,951
$75,647
$+7,696
$1,815
$2,456
$3,098
$3,739
$4,380
$5,022
$5,663
$6,304
$ +642
$ 419
$ 567
$ 715
$ 863
$1,011
$1,159
$1,307
$1,455
$ +148
The child is a state ward or is in an institution for the neglected or delinquent:  Yes  No
ADDITIONAL COMMENTS
 I have read and understand the registration and residency requirements for the Newton Public
Schools and am aware that it is my obligation to inform my child’s school if there is a change in the
residency of my family or guardianship of my child.
I swear under the pains and penalties of perjury that the answers above are true and accurate.
Signature of Parent/Legal Guardian
Date
Print Name
Signature of Student (if over 18 years of age)
Date
Print Name
Newton Public Schools Registration Form
Page 8