Initial Registration Survey

Please complete the information below and then click the Registration Page link at the bottom of this survey. Please download and complete the forms found on the Registration Page.

Student Name Student Name First Last
Student Birth Date Student Birth Date / MM / DD YYYY
Incoming Grade Level
Name of school student is currently attending.
Address Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Phone Phone - ### - ### ####
Parent/Guardian Name Parent/Guardian Name First Last
Parent/Guardian Email
Has student ever attended a Pasco County Public School?
Name of Pasco County Public School
Has student been identified as a Special Education Student? Does student have a current IEP or EP?

Has student been identified as a Special Education Student? Does student have a current IEP or EP? Yes - If yes, please complete the Consent Form for Accommodations Request located on the Registration link. No
Does student have a current 504 Plan?

Does student have a current 504 Plan? Yes - If yes, please complete the Consent Form for Accommodations Request located on the Registration link. No
Has student been identified as an English As A Second Language Learner (ESOL)

Has student been identified as an English As A Second Language Learner (ESOL) Yes - If yes, please complete the Consent Form for EL Supports located on the Registration link. No
Please complete the registration forms found on the Registration Page: Click here

Initial Registration Survey

Initial Registration Survey

Please complete the registration forms found on the Registration Page: Click here