Bokoshe Public School

Please Fill Out The Online Enrollment Form 2022-2023 Below

Date of Enrollment

Hispanic

Reaquired field: Yes

Reaquired field: No

Gender

Male

Female

Grade Enrolled In

Last Name

First Name

Phone Number

Race

Date of Birth

Place of Birth

Social Security Number

Reaquired field: Street/PO Box

Address

City

State / Province / Region

Zipcode Min: 1 Max: 5

Country

Parent/Guardian

Parent/Guardian Phone Number

Parent/Guardian Number

Home

Cell

In Case of Emergency Contact:

Emergency Contact Phone Number

Last School Attended

Transportation

Bus

Walker

Other

Has child been enrolled in special classes

Reaquired field: Yes

Reaquired field: No

List any medical conditions or medications

Child may be picked up by (name and phone number)

Required Fields