Application For Enrollment
Student Basic Information
Legal Parent/Guardian #2
Is there another legal parent/guardian?
Please list at least one emergency contact
State Board of Education Approved Home Language Survey*
The Grand Rapids Child Discovery Center is collecting information regarding the language background of each
of its students. This information will be used by the district to determine the number of children who should be
provided bilingual instruction according to Sections 380.1151 - 380.1158 of the School Code of 1976, Michigan's
Bilingual Education Law. Would you please help by providing the following information?
Thank you very much
for your cooperation.
1 "Primary language" means "dominant language used by a person for communication."
* Translation of the questions in this section in Spanish, Arabic, French, Italian, and Ojibwa is available at the Office of Field Service
Where is the student currently living? (select one)
In permanent housingIn a shelterIn transitional housingAwaiting foster care placement or within first 6 months of foster placementIn a hotel/motelWith another family or person because of loss of housing or economic hardshipIn a car, park, camper, abandoned building, etc. (unsheltered)Other temporary living situation
Race & Ethnicity Information
Please answer both parts A and B
Part B. What is the student’s race? (Choose one or more)
NOTE: Both parts A and B must be completed. We encourage you to select an answer for both parts. If either part (A or B) is not answered, the U.S. Department of Education requires the school district to supply an answer on your behalf.
Thank you for completing the enrollment application for the Grand Rapids Child Discovery Center. Please review your answers and ensure all responses are answered to the best of your knowledge. When you have done so please click the button below.