Student Registration (K-12)

2025-26 Student Registration

Kindergarten - 12th Grade
What grade will your student be entering in the 2025-26 school year? *
Finding Your Student's School

All families should verify their student's school district prior to registering. Follow the directions under "Locating District Information" on the JCS Finding Bus Stop Information page.
What school is your student districted to attend? *

Registration Documents
Required Documentation for Registration

You will be asked to upload these documents at the end of the form.
- State-certified birth record
- Immunization record
- Proof of residency
  - a copy of utility bill showing parent/guardian name and address; OR a copy of lease agreement/mortgage; OR a Jefferson Social Service benefits card or papers with parent/guardian name and address
- Caregivers/Guardians/Parents must present valid ID for verification purposes
- Caregiver Authorization Form (If needed)
The JCS New Student Registration Packet includes the following forms:
- Student contact information
- Student medical information
- Home language survey
- Student residency
- Registration statement of suspension or expulsion
- Consent for release of information
- Transportation Declaration Form

Kindergarten Registration
Required Documentation for Kindergarten Registration

You will be asked to upload these documents at the end of the form.
- State-certified birth record
- Immunization record
- Caregivers/Guardians/Parents must present valid Id for verification purpose
- Health Form
- Dental Form
- Proof of residency (provide 1)
  - a copy of utility bill showing parent/guardian name and address
  - a copy of lease agreement/mortgage
  - a Jefferson Social Service benefits card or papers with parent/guardian name and address
- Custody Agreement (if applicable)
Nice to Haves
- Social Security Card
- Last Report Card (if applicable)
- IEP/504 (if applicable)

Student Information
Name*

First NameMiddle NameLast NameSuffix
Age*
Student Birth Country*
Student Birth City *
Student Birth State*
Student Social Security Number*
Student Gender*
Options reflect available selections in WV Student Information System
Student Date of Birth*

MonthDayYear
Date
Student Race*
Hold Alt to select multiple
Student Ethnicity*
Student Home Language*
What is the language spoken in the student's home?
Number of years the student has resided in the United States
Please type in whole numbers, such as 1 or 3
Estimated date first enrolled in a US school

MonthDayYear
Date
Does the student have an IEP or 504 plan?*

YesNo
Is there a custody agreement for your student?*

Yes (please upload the agreement at the end of the form)No
Does your student have special medical needs the school nurse needs to be aware of?*

YesNo
Is this an athletics only registration? Select yes if your student is attending school outside of Jefferson County Schools and is registering only to participate in athletics or extracurriculars.

YesNo

Siblings in Jefferson County Schools
Sibling 1 Full Name
School Attending
Sibling 2 Full Name
School Attending
Sibling 3 Full Name
School Attending
Household Information

JCS recognizes that many of our students live in multiple households. To ensure we have the best contact information available for every student, please provide all available information for all households.
1 Household Families

If your student resides only in one household, you will put all information in Household 1. Parent/Caregiver 1 will be the primary contact, and Parent/Caregiver 2 will be the secondary contact. You will not put anything in for Household 2

2 Household Families

If your student resides in two households, Parent/Caregiver 1 in Household 1 will be the primary guardian, and Parent/Caregiver 1 in Household 2 will be the secondary guardian. Parent/Caregiver 2 in both households will be the tertiary or third guardian.
Does your student live in more than one household?*

YesNo
Household 1
Physical Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Is your physical address the same as your mailing address?*

YesNo
Mailing Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent/Caregiver 1 - Full Name*
This will be the primary contact for all information.
Parent/Caregiver 1 - Relationship to Student
Parent/Caregiver 1 - Email*
example@example.com
Parent/Caregiver 1 - Cell Phone *
Parent/Caregiver 1 - Landline or Home Phone*
Please enter a valid phone number.
Parent/Caregiver 1 - Employer*
Parent/Caregiver 1 - Occupation*
Parent/Caregiver 1 - Work Number
Please enter a valid phone number.
Is a translator needed to communicate with Parent/Caregiver 1?*
What language does Parent/Caregiver 1 speak?

Parent/Caregiver 2
Parent/Caregiver 2 - Full Name
Parent/Caregiver 2 - Relationship to Student
Parent/Caregiver 2 - Email
example@example.com
Parent/Caregiver 2 - Cell Phone
Parent/Caregiver 2 - Landline or Home Phone
Please enter a valid phone number.
Parent/Caregiver 2 - Employer
Parent/Caregiver 2 - Occupation
Parent/Caregiver 2 - Work Number
Please enter a valid phone number.
Is a translator needed to communicate with Parent/Caregiver 2?
What language does Parent/Caregiver 2 speak?

Household 2
Physical Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Is your physical address the same as your mailing address?

YesNo
Mailing Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent/Caregiver 1 - Name
This will be the student's secondary guardian.
Parent/Caregiver 1 - Relationship to Student
Parent/Caregiver 1 - Cell Phone
Parent/Guardian 1 - Email
example@example.com
Parent/Guardian 1 - Landline or Home Phone
Parent/Guardian 1 - Employer
Parent/Caregiver 1 - Occupation
Parent/Caregiver 1 - Work Number
Please enter a valid phone number.
Is a translator needed to communicate with Parent/Guardian 1?
What language does Parent/Caregiver 1 speak?

Parent/Caregiver 2
Parent/Caregiver 2 - Full Name
Parent/Caregiver 2 - Relationship to Student
Parent/Caregiver 2 - Cell Phone
Parent/Caregiver 2 - Email
example@example.com
Parent/Caregiver 2 - Landline or Home Phone
Please enter a valid phone number.
Parent/Caregiver 2 - Employer
Parent/Caregiver 2 - Occupation
Parent/Caregiver 2 - Work Number
Please enter a valid phone number.
Is a translator needed to communicate with Parent/Caregiver 2?
What language does Parent/Caregiver 2 speak?

Emergency Contacts

Emergency Contact 1
Full Name*
Relationship to Student*
Phone Number *
Is a translator needed to communicate with emergency contact 1?*
What language does emergency contact 1 speak?

Emergency Contact 2
Full Name
Relationship to Student
Phone Number
Is a translator needed to communicate with emergency contact 2?
What language does emergency contact 2 speak?

Emergency Contact 3
Name
Relationship to Student
Phone Number
Is a translator needed to communicate with emergency contact 3?
What language does emergency contact 3 speak?

Emergency Contact 4
Name
Phone Number
Relationship to Student
Is a translator needed to communicate with emergency contact 4?
What language does emergency contact 4 speak?

Registration Statement for Suspension/Expulsion
West Virginia State Code § 18-5-15f requires anyone wishing to register students in a Jefferson County school to first complete a Registration Statement for Suspension or Expulsion. The parent, guardian, or custodian of the student must complete this form before Jefferson County Schools can request records or register any student.

West Virginia State Code § 39-1-10a states any certificate, return, form, statement, or other document which isrequired by the State of West Virginia, or any office, department or agency thereof, and which does not requirean acknowledgment under this article or other laws of recordation of the State of West Virginia, may be verifiedby written declaration that it is made under the penalties of perjury and such declaration shall be in lieu of any oath otherwise required.

Any person making any false statement in any certificate, return, statement, or other document verified by such written declaration shall be subject to the same penalties as would be applicable had the same been verified by oath duly taken and acknowledged.

Any student who has been suspended or expelled from a public or private school in another West Virginia county, or a public or private school in another state pursuant to § 18A-5-1a, may not be admitted to a Jefferson County school until the period of suspension or expulsion has expired. However, that student may be eligible for enrollment in an alternative program offered by Jefferson County Board of Education. In the event that a student who is currently suspended or expelled registers to attend a Jefferson County School, the school principal will convene a SAT meeting to determine the student’s placement until the suspension or expulsion has expired(§18-5-15f)
Is your student under suspension or expulsion from attendance at a public or private school in West Virginia or any other state*

YesNo

Release of Information
Has your student previously attended any school?

YesNo
School your student most recently attended
Previous school address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Previous school phone number
Please enter a valid phone number.
Date when student was enrolled

MonthDayYear
Date

Uploads

Please upload all documents you have available this will expedite your registration process.
State-certified Birth Record

Cancelof
Immunization Record

Cancelof
Proof of Residence

Acceptable Documents: a copy of utility bill showing parent/guardian name and address, a copy of lease agreement/mortgage, a Jefferson Social Service benefits card or papers with parent/guardian name and address
Cancelof
Caregivers/Guardians/Parents - Valid ID

Cancelof
Custody Paperwork

Cancelof
IEP/504

Cancelof
Kindergarten Health Form

Cancelof
Kindergarten Dental Form

Cancelof

Submission
By signing below I acknowledge that all submitted information is correct, and I have the right and ability to enroll this student in Jefferson County Schools.
Signature

Clear
Type Full Name
Date

MonthDayYear
Date
Hidden Section
Locations
Enrollment 1
example@example.com
Enrollment 2
example@example.com
Should be Empty:

2025-26 Student Registration

Registration Documents

Kindergarten Registration

Student Information

Siblings in Jefferson County Schools

Household Information

Household 1

Household 2

Emergency Contacts

Notices and Agreements

Registration Statement for Suspension/Expulsion

Release of Information

Student Medical Information

Students Physician Information

Student Medical Information

STUDENT RESIDENCY

Uploads

Submission

Hidden Section