Midd-West School District
Dear Parents:
The following pages of information must be printed and completed by appropriate parties to register your child for kindergarten. If you are unable to print the documents, please stop by the office of the elementary school where they will attend and pick up a registration packet. Please drop off your completed paperwork or mail it to your neighborhood school by March 31st, 2023. If you have any questions, please call the office at (570) 837-0046. (To open the 2023 packet, click here, https://5il.co/1nayy)
·Official birth certificate of student
·Immunization records (you can get a copy of your child’s immunization records from your child’s physician). Every child in grades K12 must be immunized, unless exempt for medical reason, religious belief or philosophical/strong moral or ethical conviction.
·Proof of residence in Midd-West Area School District (one of the following):
·lease (renter)
·current utility bill
·current check stub for wages, public
assistance, social security or other
source of income indicating the address
within the district
·current credit card bill
·current property tax bill
·current identification card (state issued)
·current vehicle registration
·Pennsylvania driver’s license indicating
the address within the District
Page 1 –Student Registration Form (2 copies) Both must be completed. Be sure to spell the child’s name as it appears on his/her birth certificate. Bring Proof of residency.
Page 2 –Hearing and Vision Screen Survey
Page 3 –Speech and Language Survey
Complete the top section of these forms. They will be used during kindergarten registration.
Page 4, 5, 6 –Student Health History
Complete this information as accurately as possible.
Page 7 –Physical and Dental Choice
Page 8 -Private Dentist Report of Dental Examination of a Pupil of School Age
To be completed by your Dentist
Page 9 –Private Physician’s Report of Physical Examination of Pupil of School Age
To be completed by your Physician
Page 10 –Home Language Survey
Other information enclosed in this packet is not required but informational. If you have any questions concerning this information, please contact the school Nurse.
Candace K Benner, RN
570-837-0046
Middleburg Elementary ext. 4400
West Snyder Elementary ext. 5400