Application for Day Enrollment

Application for Day Enrollment

The Lac Courte Oreilles Tribal Council and School Board declares it is the policy of the Lac Courte Oreilles Ojibwe School to allow any Indian child enrolled in a federally recognized tribe, ¼ blood quantum or more Indian, a tuition free educational opportunity. Proof of ¼ Indian blood must accompany registration upon entrance. (Policy adopted by the Lac Courte Oreilles Tribal Council & School Board on May 3, 1999.)

Please complete the form below. Required fields marked with an asterisk *

Student Name*

Answer Required

Entering Grade*

Answer Required

Date of Birth*

Answer Required

Present Age*

Answer Required

Gender*

Answer Required

Community*

Answer Required

Tribal Agency Enrolled*

Answer Required

Street Address*

Answer Required

City*

Answer Required

Zip/Postal*

Answer Required

Note: When a student does not reside with both parents. Additional information must be on file so that the school can determine who is responsible for the student. If there are applicable legal documents such as custody papers or guardianship, a copy must be provided to the school. Student Resides with (check all that apply)*

Answer Required

Both parents same household

Both parents different household

Mother Only

Father Only

Legal Guardian

ICW Placement

Relative

Non-relative

Guardian Information

Legal Guardian Name*

Answer Required

Place of Employment*

Answer Required

Primary Email *

Answer Required

Secondary Email

Answer Required

Mobile Phone*

Number Required

Home Phone*

Number Required

Work Phone

Number Required

Guardian Information

Legal Guardian Name*

Answer Required

Place of Employment*

Answer Required

Primary Email*

Answer Required

Secondary Email

Answer Required

Mobile Phone*

Number Required

Home Phone*

Number Required

Work Phone

Number Required

Emergency Contact Information - In the event guardians cannot be reached

Name*

Answer Required

Relationship*

Answer Required

Community*

Answer Required

Phone*

Number Required

Name*

Answer Required

Relationship*

Answer Required

Community*

Answer Required

Phone*

Number Required

Name*

Answer Required

Relationship*

Answer Required

Community*

Answer Required

Phone*

Number Required

Sibling Information (Brothers and Sisters attending LCO School)

Name

Answer Required

Grade

Answer Required

Name

Answer Required

Grade

Answer Required

Name

Answer Required

Grade

Answer Required

School Information (Omit if student attended LCO during the previous school year)

Last School Attended

Answer Required

Year

Answer Required

Grade

Answer Required

Street Address

Answer Required

City

Answer Required

Zip/Postal

Answer Required

Child participated in

Answer Required

EBD

Speech

Gifted & Talented

I hereby agree to help my child to abide by the rules of the school, to insure my child’s participation in school activities and to the best of their ability I will support all educational, cultural, and social programs of Lac Courte Oreilles Ojibwe School.*

Answer Required

Yes

I authorized LCO Ojibwe School to obtain emergency medical treatment for my child in the event that the school is unable to contact me. I accept full financial responsibility for such treatment.*

Answer Required

Yes

I Give permission for my child to participate in all school-sponsored field trips*

Answer Required

Yes

I Give permission to videotape or photograph my child to represent my child's abilities; to record classroom events; to create books and charts to be used for educational purposes; to be published in the local news media for participation in school events.*

Answer Required

Yes

Parent/Guardian Electronic Signature*

Answer Required

Date*

Answer Required

Please fix the highlighted areas below before submitting.

Application for Day Enrollment