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Registration
This is only the first step in the process of applying to Jenks when you live outside our catchment. Please complete all questions that apply to you and your child.
* Indicates required question
Email
*
Your email
Parent's First Name
*
Your answer
Parent's Last Name
*
Your answer
New Student First Name
*
Your answer
New Student Last Name
*
Your answer
New Student's Date of Birth
*
MM
/
DD
/
YYYY
Does the student have siblings at Jenks?
*
Yes
NO
If you answered Yes, please list the sibling's names below:
*
Your answer
If you do not currently have a child at Jenks, how did you hear about Jenks?
*
Friend
School District of Philadelphia website
Other, please tell us below how you learned about Jenks
Please tell us how you learned about Jenks.
*
Your answer
Did your child attend a Pre-K Progam?
Yes
No
Clear selection
Does the new student have an IEP?
*
Yes
No
If the child has an IEP, please select the disability.
Specific learning disability
speech and language impairment
other health impairment
intellectual disability
multiple disabilities
emotional disturbance
autism
Other, please tell us below
Clear selection
Does your child have any medical conditions?
Yes
No
Clear selection
If you answered Yes above, please describe your child's medical condition.
Your answer
Does the new student speak English as a first language?
*
Yes
No
If English is not the student's first language, what is the first language spoken at home?
Your answer
If there are siblings, what language do the siblings speak?
Your answer
Home address
*
Your answer
Parent Email Address
*
Your answer
Parent Phone Number
*
Your answer
Parent electronic signature (type your full name)
*
Your answer
Any questions send an email to
asjenks252@gmail.com
Your answer
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