Please have the following documents ready (if you submit the form without them a registrar will reach out to obtain them)
  • A certified original birth certificate with seal. Child Must be 5 years of age by August 31st, 2021.
  • Two forms of proof of residency in Beverly (Click here for list of acceptable documents)
  • Updated Immunization / Proof of Physical Exam Records

If you have any technical issues with this form please email feedback@beverlyschools.org

Demographic
Registration Type
Name
Nickname
Gender
Date of Birth
Family Military Status
Student Lives With
(Check all that apply)
Address
Street Address:
City:
State:
Zip Code:
Contacts
Please include at least one contact, including parents/guardians.
Add Contact

Not authorized to pick up student
Please list anyone who is NOT authorized to pick up student.
Documentation will be required.
Not Authorized Name
Not Authorized Relationship
Medical

Health Conditions

Check all that apply
Other Health Conditions

Allergies

Over the counter medications

I give permission for the nurse to administer the following
 

Doctor and Insurance information

Physician
Physician Phone
Medical Insurance
Medical Insurance Policy #
Dentist
Dentist Phone
Dental Insurance
Dental Insurance Policy #

Medications

Remove
Medication
Medication Dose
Remove
Medication
Medication Dose
Remove
Medication
Medication Dose
Remove
Medication
Medication Dose
Remove
Medication
Medication Dose
Remove
Medication
Medication Dose
Add Medication
Vaccination Exemption
Medical Transport Consent
State Mandated Questionnaire
Are you Hispanic or Latino?


What is your race? (Please check all that apply)










Last School Attended
School Name
City
State/Country
IEP
504
LEP Services
Migrant Status
State Ward
Has student formerly attended Beverly Public Schools?
Name of Beverly School

Dates attended

Has student ever been expelled?
Has student ever been charged with a felony?
Home Language Survey
Massachusetts Department of Elementary and Secondary Education regulations require that all schools determine the language(s) spoken in each student's home in order to identify their specific language needs. This information is essential in order for schools to provide meaningful instruction for all students. If a language other than English is spoken in the home, the District is required to do further assessment of your child. Please help us meet this important requirement by answering the following questions. Thank you for your assistance.
Country of Origin
Date first Enrolled in ANY U.S. school
Has your child completed three (3) academic school years in any state of the United States?
What is the native language(s) of each parent/guardian?
What language(s) are spoken with your child (Include relatives: grandparents, uncles, aunts, etc... and caregivers)
What language did your child first understand and speak?
What language do you use most with your child?
What other languages does your child know? (Check all that apply)
What languages does your child use?
Will you require written information from school in your native language?
Will you require an interpreter/translator at Parent-Teacher meetings?
The Mckinney-Vento Homeless Education Act
The Federal McKinney-Vento Education Homeless Education Assistance Act is designed to ensure educational rights and protections for students experiencing homelessness. Homelessness is defined as children and youth who "lack a fixed, regular, and adequate nighttime residence."

Consistent with the Massachusetts Department of Elementary and Secondary Education guidelines, the Beverly Public Schools afford homeless students and unaccompanied youth special consideration in addition to access to the same free, appropriate public education and opportunities thereof, that is provided to all other children and youth living in Beverly. The district will enroll homeless students even if they do not have the documents required for enrollment, such as school records, medical records, or proof of residency. Homeless students and unaccompanied youth are entitled to receive free and reduced school meals, transportation, English language services, vocational and technical services, gifted and talented services, special education, all extra curricular activities and Title 1 services.
Do you have a fixed, regular, and adequate nighttime residence?
If no, please select the description that best describes your primary nighttime residence
Early Childhood Program Survey
A formal early childhood program is participation in a public school preschool, licensed community-based preschool/child care, Head Start program and/or licensed family child care provider for one month or more.
Has your child participated in at least one formal early childhood program (i.e., providers/programs) since September 2020 (when your child was 4)?
If no or don't know, did your child participate in a CFCE or PCHP program?
Stop here if your child did not attend an early childhood program this year (2020-2021)
What type of early childhood program(s) has your child attended since September 2020 (when your child was 4)?
On average during this year (September 2020 through August 2021) how much time per week did/will your child spend in an early childhood program(s)?
Registration Documents

If you select to not submit these forms with your online registration you will be contacted by the registrar to provide the requested documentation

A certified original birth certificate with seal. Child Must be 5 years of age by August 31st, 2021.

Two forms of proof of residency in Beverly (Click here for list of acceptable documents)


Updated Immunization / Proof of Physical Exam Records

Policies
Acceptable Use Agreement
Click here for Acceptable Use Agreement
Age Appropriate Discrimination/Harassment
Click here for Age Appropriate Discrimination/Harassment
BPS Video/Media Permission
Click here for BPS Video/Media Permission
Medication Administration
Click here for Medication Administration
Medicaid Consent
Click here for Medicaid Consent
Confirmation of Daily Student Symptoms Checking
Click here for Confirmation of Daily Student Symptoms Checking
Informational
By submitting this form I confirm that the information given in this form is accurate.
Parent/Guardian name: