Welcome to Sam Adams Elementary School!

The following documentations are needed to register:

Ø Student’s Birth Certificate

Ø Current Immunization Records

Ø One form of Verification of Residency (i.e. Electric Bill, Cell Bill)

Ø Driver’s License

• If your child has any medical needs, please provide doctor’s information and forms.

• If there are any custody issues, please provide documentation showing guardianship.

• If your child has an IEP (Individualized Education Plan), please provide any copies or information to enrollment staff.

If you have any questions, please feel free to contact our office at 445.0517.

Enrollment Information

Download the forms and save the documents to your device before typing information. When enrollment forms are complete, please email them to Mrs. Blaske, jblaske@cassopolis.org.

	Registration Form
	Home Language Survey
	Reporting Military Form
	Birth Certificate Verification Form
	Disclosure of Immunization Form
	Medication Request Form
	Prior Care Form
	31a Data Reporting Form
	Permission/Participation Form
	Parent/Student/Staff Compact
	Transportation Request Form
	Alternative Bus Stop