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Student Enrollment Form Application

Mitchell County School System (MCSS): Student Enrollment Form

Please complete the form below for each new student enrolling in the Mitchell County School System.

Student's Last Name:

Answer Required

Student's First Name:

Answer Required

Student's Middle Name:

Answer Required

Student's Date of Birth:

Answer Required

Gender:

Answer Required

Male

Female

Race/Ethnicity:

Answer Required

African American

Caucasian

Hispanic

Asian

Other

Parent First Name

Answer Required

Parent's Last Name

Answer Required

Email 1

Answer Required

Mobile Phone

Number Required

Address

Street Address

Answer Required

City

Answer Required

Zip/Postal

Answer Required

Parents: if possible please mail a copy of your child's immunization record, social security card, Ear-Eye-and Dental Form and birth certificate and Proof of Residency to:

Lytresa Sanders

Mitchell County Board Office

108 South Harney Street

Camilla, GA 31730

take a picture of the document and email it to her at lytresa_sanders@mitchell.k12.ga.us.