Registration Forms

Please complete these forms, print them, and take them to the Jersey Shore Area School District Administration Building–Central Registration Office. All forms are in Adobe Acrobat format, and the free Adobe Acrobat Reader is required on your computer to open them. You can pre-register with this link: Focus Parent Portal. The Central Registration Office will then contact you to make an appointment to complete the registration process.

Form #1 — New Student Registration Form

Form #2 — Request for Pupil Records

Form #3 — Home Language Survey

Form #4 — House Bill 26–Safe School Initiative

Form #5 — Child Custody Information Form

Form #6 — Media Release Opt-Out Form 

Form #7 — Special Education Annual Notice

Form #8 — FERPA Rights

Form #9 — Medical Forms Cover Sheet

• Medical Form A — Health History
• Medical Form B — Medical Screening Acknowledgement
• Medical Form C — Physical Exam
• Medical Form D — Dental Exam

General Emergency Form — Emergency/Information Change Form

Health Emergency Forms —
Authorization for First Aid/Emergency Care
Medication Permission Form

Along with the above forms, the following documents are needed to register a child in the district:

• Birth Certificate
• Last Report Card from Previous School
• Immunization Record
• Child’s IEP (if applicable)
• Custody Documentation (if applicable)
• Foster Care Documentation (if applicable)
• Proof of Residency for the Parent (utility bill, paystub)

If you have any questions, please contact:
Joanne Knepp
Student Data Coordinator
Jersey Shore Area School District
175 A&P Drive
Jersey Shore PA 17740
jknepp@jsasd.org
Ph:  570-398-5253
Fx:  570-398-5089