Excelsior Charter School's
Student Registration System

Student Registration

Please enter your student's information below

First NameMiddle NameLast Name
Year Applying For?BirthplaceZip Code
BirthdateStateGender
Street Address
CitySS NumberGrade entering in August, 2019Last School
What programs and interventions does student receive?Does this child receive ESE services?Student lives with
Martial status of parentsRaceCountyHome Phone
The next page will allow you to enter information about this student's parents/guardians and siblings. In order to prepare the page, please enter how many of each you would like to enter.
Number of Parents/GuardiansNumber of Siblings
Student Registration System • © 2014 • Charter School Services Corporation