Registration Form K-12

Registration for all students in K-12
  • assigned school based on physical address
  • Enter house number and street or PO Box
  • Enter house number and street
  • Select one
  • What is your child's race? * Required
    Check all that apply.
  • City/State
  • For example: English, Spanish, Italian, Chinese, Arabic
  • Volume/State File Number
  • First, Middle, Last
  • Enter house number and street or PO Box
  • City, State
  • high school, 2 yr, 4 yr, post grad
  • Business
  • number, street, city, state, zip
  • First, Middle, Last
  • Enter house number and street or PO Box
  • City, State
  • high school, 2 yr, 4 yr, post grad
  • Business
  • number, street, city, state, zip
  • Enter date
  • Enter city/county, state
  • Check all that apply * Required
  • A copy of the Custody Order including visitation rights during the school day must be provided.

  • first and last
  • If different from above
  • if different from above
  • Please answer the following questions:

  • Write number, ages, and school, if none state none
  • Write number, ages, and school, if none state none
  • name(s) and relation(s) if any, if not state none
  • Approximate if not known
  • Name and relationship to child
  • street number, city, state, zip code
  • Name and relationship to child
  • street number, city, state, zip code
  • street number, city, state, zip
  • Previous school (if applicable) and address; state none if none
  • Please read and sign the statement below:

    I am a resident of Dinwiddie County and live in the district in which I am registering. I realize that any person making a false statement concerning the residency of a child in a particular school division shall be guilty of a Class 4 misdemeanor pursuant to the Code of Virginia: 22.1-264.1. If there are custody issues regarding this child, I will provide a copy of the custody order and visitation rights. I also certify that this child is a student in good standing (not suspended or expelled from any public/private school, nor found guilty of or is an adjudicated delinquent for any offense in subseciton G of the Code of Virginia: 16.1-260)
  • enter first and last name