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Contact Mrs. Schreier at (920) 349-8109, or schreierl@hustisford.k12.wi.us, if you have any questions.
Do you live within the Hustisford School District?
If you do not live within the Hustisford School District, have you been approved for open enrollment?
Has your student previously attended Hustisford?
Student's Legal First Name (will need to show proof of identity, see details on website):
Student's Legal Middle Name (will need to show proof of identity, see details on website):
Student's Legal Last Name (will need to show proof of identity, see details on website):
Date of Birth:
Birth City, County, State, Country:
Gender:
Student Address Street, City, State, Zip:
Current School Year Grade Level:
Current/Previous School Name, City, State:
Primary Guardian First & Last Name:
Primary Guardian Relationship:
Primary Guardian Phone Number:
Primary Guardian Home Address (Street, City, State, ZIP)
Primary Guardian Mailing Address (Street, City, State, ZIP)
Primary Guardian Email Address:
Second Guardian First & Last Name:
Second Guardian Relationship:
Second Guardian Phone Number:
Second Guardian Home Address (Street, City, State, ZIP)
Secondary Guardian Mailing Address (Street, City, State, ZIP)
Second Guardian Email Address:
My child lives with
Does this student have a sibling attending Hustisford?
What is the primary language spoken at home?
Does this student have an active IEP (Individualized Education Plan)?
Does this student have an active 504 plan?
Has my son/daughter been expelled from a previous school district pursuant to Section (120.13)(1)(f)
What is the anticipated start date?
Name of the person completing this form.
* Enter Your Email Address:
