Moline School District No. 40 Registration Information
Returning students please click here to view information about 2013-2014 Registration
Registration Forms For NEW Students to the District -
K-8 Grade
Download and print the forms below to fill out prior to arriving to register your child(ren). You will need one form for each child being registered.
- Registration Form
- Ethnicity Form
- Physical Examination Form (All students coming to Moline from outside of Illinois)
- Proof of residency and demographic release form (For information about acceptable proofs of residency click here
- Interpreter Request Form (Spanish) (French)
- Family Access Form
- Athletic Participation Form (7th and 8th graders only)
- Dental Exam Form (Kindergarten, 2nd and 6th grade students only)
- Eye Exam Form (Required for Kindergarten and upon first entry into an Illinois school beyond kindergarten)
Call (309) 743-1624 to schedule an appointment to meet with a counselor. Download and print the forms below to fill out prior to arriving to register your child(ren). You will need one form for each child being registered.
- Registration Form
- Ethnicity Form
- Physical Examination Form (All students coming to Moline from outside of Illinois)
- Proof of residency and demographic release form (For information about acceptable proofs of residency click here
- Interpreter Request Form (Spanish) (French)
- Family Access Form
- Eye Exam Form (Required upon first entry into an Illinois school)
- Good Standing Certification (Required for students entering from out of state public schools)
Other Health and Safety Forms for all Grades
- Student Athletic Physical Form (All students wanting to participate in an athletic sport)
- Health Requirements Letter
- Medication Letter
- Eye Exam Waiver
- Dental Exam Waiver
- Community Resources
***NOTE: Special instructions regarding the student physical examination form. If you are attending the free physical at the beginning of the school year you will have to print this form and pre-fill the form as completely as possible and have your student bring the pre-filled form to the examination. Any student that attempts to attend the free physical examination without the form pre-filled by a parent or guardian will not be able to attend the free physical examination.
******ATTENTION******
During the student registration process, parents/ guardians will be required to provide documentation for both student enrollment and residency. Before the registration process can be completed, a child’s parent/ guardian must provide proof of residency. Illinois School Code states that a child is entitled to enrollment in a district wherein he/she resides. The code further defines residence as a physical presence with an intention to remain on a permanent basis with the person(s) who have legal custody of the child.
Proof of residency requires documentation with matching address of residence from each of the following categories to complete the registration process:
Residency Combination Options:
Category I - 2
Category II - 1
OR
Category I - 1
Category II - 2
Category I
- Mortgage Document (Homeowners)
- Current Lease (Signed & dated)
- Property Tax Bill (Rock Island County Tax Statement, most recent bill)
- Trailer Park Residents (Letter from manager or signed and dated agreement)
- Letter of residence (citing address) from landlord in lieu of lease (Must include contact phone number for landlord)
- Most recent gas, electric, and/or water bill
- Most recent cable television bill
Category II
- Driver’s license or state identification card
- Vehicle registration, title or registration card
- Vehicle Insurance Card with address
- Voter registration card
- Current public aid card with address
- Home/Rental Insurance Policy and receipt of payment
- Residential service contract (e.g., appliance repair, exterminator, plumber, etc.)
- Pay check or pay stub
- Checking or savings account statement
- Major credit card bill
- Installment loan contract from bank or other financial institution
- Canceled checks with imprinted name or address
The district is aware that, for some families, circumstances may require that additional information be provided in order to adequately meet the requirements for proving residency. Below are several examples for which additional documentation will be required to assist in completing the student registration process.
- If the parent/guardian resides with a district resident, the district resident must provide the residency information for category one and up to two documents from category two. The parent/guardian must supply at least one proof of residency from category two. The ISBE Form 85-51, Affidavit of Enrollment and Residency, must be completed and signed.
- If you are a non-parent seeking to enroll a student, you must complete and sign ISBE Form 85-51, Affidavit of Enrollment and Residency. You must also provide the residency information for category one and up to two documents from category two.
Falsifying residency information for the purpose of a child attending school in a district is a Class C Misdemeanor.
If a student is determined to be a non-resident of Moline School District for whom tuition must be charged, the person(s) enrolling the student is/are liable for non-resident tuition from the date the student began attending as a non-resident.
The Moline School District reserves the right to evaluate the evidence presented. Merely presenting the items listed in the documentation procedure does not guarantee admission.
To download and fill out an AFFIDAVIT OF ENROLLMENT AND RESIDENCY please click here
When you register, don't forget:
- Completed physical exam form (required for incoming pre-school, kindergarten, 6th grade, 9th grade, and new students)
- Documented proof from a physician/medical professional of receipt of T-dap vaccination for students in 6th-12th grades
- (for first year students) Certified copy of student's birth certificate issued by county, state, or other reliable proof of age & identity
- Student's Social Security number
- Money for student book fee (make checks payable to Moline Board of Education)
- Waiver of fees identification
- Don't forget to join your school's Parent Teacher Association (PTA)
- Medicaid/Link card
- Phone numbers of emergency contact persons, & doctor
All families registering students in the Moline School System must live within the boundaries of Moline School District No. 40 and within the boundaries of that school unless they have received transfer permission in writing from the Board of Education office. Families that fill out the registration form stating an address within Moline or Coal Valley must live at that address. If it is found that false information was provided to the school, and the student(s) live outside of Moline School District No. 40, these families will be required to register their children within the community where they live. They will also be required to pay all out-of-district tuition and fees as provided by law for the time any children attended Moline or Coal Valley schools illegally.
Commonly Asked Questions about Registration:
1.
Why is registration held annually?
The health and safety of our students is important. We
ask you to fill out an emergency information/registration
card each year to re-verify parent/guardian work phone
numbers, emergency contact persons, and the name of your
doctor. In a medical emergency with your child, this
information is critical. Coming to school for registration
also helps
you and your child meet the school staff and perhaps
see the school before the first day.
2.
I'm new to the school
district and need a class supply list. Where do I find
one if my school isn't open yet?
Copies of all school and classroom supply lists are
available by calling the school district offices located
at the
building called Allendale - 1619 11th Avenue, Moline,
743-1600.
Summer hours 8 a.m. - 4 p.m.
3. Are my children allowed to come to registration?
The child(ren)you are registering as well as your other children are most certainly allowed to come to registration.
4. What if our family can't afford the textbook fee?
If you receive aid under Article IV of the Illinois
Public Aid Code or meet income guidelines for free
lunch, the
Board of Education will loan you free textbooks.
