Genesee STEM Academy

Genesee County's First S.T.E.M Certified School

Summer Countdown
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New Student Pre-Registration Form

Enrollment Form 2016-17 School Year

This is a mandatory form for enrollment and must be completed each school year.�
Child's legal Name*
Address:*
Mobile:
-
Parent/Guardian #1:*
What grade will your child enter in the new school year?*
Please list if your child receive special education and/or speech services, hospital preference, and health conditions. *
When is the best time to contact you:
E-mail:*
Type the characters you see here:

* Indicates required fields

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