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  • BLOOMINGDALE ELEMENTARY SCHOOLS

    Mr. Patrick R Haugens Principal

    Mrs. Stacy Johnston Assistant Principal

    Erickson Elementary School

    277 Springfield Drive Bloomingdale, IL 60108 Phone: 630-529-2223

    Fax: 630-893-9849 www.sd13.org

    Developing Actively Involved Learners and Responsible Citizens

    In Partnership with the Community

    February 1, 2016

    Dear Parents,

    It is time to register your kindergarten student for the 2016-2017 school year. Eligible students must be 5

    years of age on or before September 1, 2016.

    Kindergarten Registration will take place from February 16th through February 19th in the Erickson

    Elementary office. The Erickson office will be open until 6:00pm on Wednesday, February 17th to assist

    with registration.

    All parents must include a certified birth certificate for your child with registration material. The

    school will make a copy of the birth certificate and return the original to you. In addition parents will

    need to provide multiple documents to prove residency.

    Completing these forms at home will reduce the amount of time it will take you to complete the

    registration process. Please review the registration checklist to ensure all the necessary documents are

    completed.

    We are very excited to welcome your child to the Erickson family and look forward to seeing them soar

    like an Eagle.

    If you have any questions, please contact the building principal by phone 630-529-2223 or email

    phaugens@sd13.org.

    Sincerely,

    Patrick Haugens

    Principal

    mailto:phaugens@sd13.org

  • BLOOMINGDALE SCHOOL DISTRICT 13 2016-2017 KINDERGARTEN REGISTRATION CHECKLIST

    *Please return this sheet with completed documents to the school office. Students Legal Name ________________________________________________________________

    School _____________________________________________________________________________

    Proof of Residency Three documents are required as shown on the Proof of Residency form. A child cannot start until the residency requirement is complete.

    Certified Birth Certificate. Please have the parent contact the appropriate county office vital records department to obtain the official birth record for their child. Phone numbers for surrounding counties are: DuPage County 630-682-7400; Cook County 866.252.8974; Kane County 630-232-5950; Lake County 847-377-2400. The parent can also go to a local Currency Exchange to obtain a birth certificate.

    Seven registration forms: Proof of Residency Sheet

    Student Registration & Emergency Consent Form Ethnicity/Race Letter and Form Class Placement Background Information Sheet

    Language Survey Medical Information/Release Form

    Military Letter

    Student fees. These fees are current fees that should be paid as part of registration. If fees are paid at a later date, they will be next years fees.

    Student textbook fees ($50.00) mandatory

    Student technology Fee ($50.00) mandatory Student milk fees ($22.00) optional Student bus fees ($375.00) when applicable

    Optional Forms. Affidavit Fee Waiver

  • BLOOMINGDALESCHOOLDISTRICT1320162017PROOFOFRESIDENCYFORM

    (StudentsmustbeDistrictresidentsasofAugust17,2016)

    ALLDOCUMENTSACCEPTEDFORPROOFOFRESIDENCYMUSTHAVETHESAMEADDRESS:

    CategoryI:Provideoneofthefollowingdocuments: IllinoisDriversLicense IllinoisStateID OtherPhotoID

    CategoryII:Provideoneofthefollowingdocuments: Currentmortgagestatementorclosingstatementfrombankorlender Realestatetaxbillfromcurrentschoolyear Currentleaseshowingthename,addressandphonenumberoflandlord NotarizedAffidavitofResidencyFormincludingnamesofstudentslivingintheresidence

    CategoryIII:Provideoneofthefollowingdocuments: Currentelectric,water,gasorcable/internetbillinyourname ValidIllinoisvehicleregistration Currentpaystubfromyouremployer CurrentpublicaidcardordocumentfromDHSorDCFSthatincludesyournameThisproofofresidencyformistoattestthatthechildisnotenrollingintheDistrictsolelyforschoolpurposesand is livingonapermanentbasiswiththepersonhavingcompletecustodyandcontrol. Registrationofastudentwhoisnotaresidentisafraudulentact.Anystudentfoundtohavebeenfraudulentlyregisteredwillbedropped from theattendance rolls immediately. Parentsorguardiansmakinga fraudulent registrationwillbesubjecttothepaymentofretroactivetuitionchargedfornonresidentstudents,nottoexceed110%ofthepercapitacost.ApersonwhoknowinglyorwillfullypresentstheDistrictwithanyfalseinformationregardingtheresidencyofapupilforthepurposeofenablingthatpupiltoattendanyschoolintheDistrictshall have committed a Class C misdemeanor and shall be prosecuted by the District. NationalInvestigations,Inc.willbeconductingahomevisitiffraudissuspected.IcertifythatIunderstandtheresidencyrequirementsandthatIknowthepenaltyforfraudulentregistration.

    Parent/GuardianSignature___________________________________Date ___________________

    Parent/GuardianAddress_________________________________Telephone______________

    NameofStudent_______________________________________ School__________________

    NameofStudent_______________________________________ School__________________

    NameofStudent_______________________________________ School__________________

    NameofStudent_______________________________________ School__________________

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    Technology Fee

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