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Blix Elementary

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Fill out the form below to enroll your child today!

Student's First Name:

Student's Last Name:

Parent/Guardian's First Name:

Parent/Guardian's Last Name:

Parent/Guardian phone number:

Parent/Guardian email:

Student's age:

Student's date of birth

Choose the gender identity that your child uses:
Male Female Non-binary

Which of the following best describes your child's race/ethnicity? (Check all that apply)

Asian, Asian American or Pacific Islander
Black or African American
Hispanic or Latin American
Alaskan Native or Native American
White, Caucasian or Euro American
Multiracial or Biracial
A race or ethnicity not listed here
I prefer not to disclose

Select your child's upcoming grade level:

Which school are you interested in enrolling your child in?