* Required

NRCCS K-8 Intent to Enroll in Future Years

Student Personal Information

Firstrequired

Middle

Lastrequired

Gender*

Male Female

Student Goes By:required

Student to Enter Grade:required

Date of Birthrequired (mm/dd/yyyy)

Country of Birth:required

Family Household Information

Student Lives with:*

Both parents, same residence Each parent, separate residences Mother only Father only Mother/stepfather Father/stepmother Legal guardian Grandparent Other

This student lives:*

Within SSSD boundary Outside SSSD boundary

Does your student need transportation service between Steamboat Springs and NRCCS?*

Every day Periodically Never

Primary Household Information

This is where the student resides the majority of the time during the school year.

Parent/Guardian Firstrequired

Parent/Guardian Lastrequired

Relationship to Studentrequired

Cell Phonerequired

Address 1required

Address 2

Cityrequired

Staterequired

Ziprequired

Is this address on County Road 52--or north and accessible from County Road 129 (within the North Routt Fire Protection District?)*

Yes No

Submission of Intent to Enroll

Parent/Guardian Emailrequired

Date of Submissionrequired (mm/dd/yyyy)

Please send a confirmation email to the address below:

Please provide an email address where we can send a link to your current form.

Email Address :