TEANECK PUBLIC SCHOOLS 651 Teaneck Road Teaneck, New Jersey 07666 www.teaneckschools.org

MANDATORY REGISTRATION / RESIDENCY REQUIREMENTS

Registration and residency forms are to be completed and submitted to the Teaneck Board of Education Central Registration Office. You can send via email to registrar@teaneckschools.org or make an appointment to drop off documentation at the Registration Office located at 651 Teaneck Road. Registration Office hours vary by time of year, please call (201) 833-5512 to confirm hours.

Regular Registration Office hours are as follows: Monday through Friday 9:00 a.m. – 3:30 p.m.
(The office will be closed for lunch from 12:00 p.m. to 1:00 p.m.)

For evening appointments, please contact the registrar at (201) 833-5512 or via email at registrar@teaneckschools.org.

If you have a question regarding residency or registration requirements, please contact Ms. Rose Antinori, Registrar at (201) 833-5512 or via email at registrar@teaneckschools.org.

The following documents will be accepted for consideration at the time of registration: (All documents must be officially translated in English)

A. Original Birth Certificate (Passport can be used to establish official date of birth if birth certificate is not available).

B. Record of Immunization. New Jersey State Law prohibits students from entering school without a Record of Immunization. Documentation must have the student’s legal name.

C. Proof of Residency – See next page for list of acceptable proof of residency.

D. Name and address of previous school for transcript purposes.

E. Custodial documents if applicable

After residency is established and verified:

A. You must call to schedule an appointment with the school that your child will attend.

B. You will need to bring the following documentation with you to finish the registration process at the school:

i. Registration packet provide by the registrar at Central Office

ii. Birth Certificate

iii. Immunization Records

iv. Recent Report Card/Transcript

v. Transfer Card

vi. ISP/IEP/504 Plan if applicable

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TEANECK PUBLIC SCHOOLS 651 Teaneck Road Teaneck, New Jersey 07666 www.teaneckschools.org

ACCEPTABLE PROOF OF RESIDENCY

OPTION 1: IF YOU OWN A HOME

1. Please provide a copy of your current property tax bill, tax assessment card, a copy of your deed or a recent mortgage statement.

AND

2.	Most recent utility bill (i.e. PSE&G, water company, cable, telephone bill).

OPTION 2: IF YOU LEASE

1. Please provide a current copy of your lease and it must include the name of the parent/guardian. AND
2.	Most recent utility bill (i.e. PSE&G, water company, cable, telephone bill).

OPTION 3: IF YOU RENT AND DO NOT HAVE A LEASE

1. You must have the owner/landlord of the property complete an Affidavit of Landlord form. The owner of the property must sign the form and have it notarized.

AND

2. The owner must provide a copy of the current property tax bill, tax assessment card, a copy of the deed, or a recent mortgage statement.

AND

3. Copy of your (Parent/Guardian) most recent utility bill (i.e. PSE&G, water company, cable, telephone bill).

OPTION 4: IF IT IS A PRIVATE HOME AND YOU DO NOT PAY RENT

1. You must have the owner/landlord of the property complete an Affidavit of Landlord form. The owner of the property must sign the form and have it notarized. You do not need to disclose any rent amount on the

form. AND
2. The owner must provide a copy of their current property tax bill, tax assessment card, a copy of the deed, or a mortgage statement.

AND

3. The parent/guardian must provide a copy of a current utility bill (i.e. PSE&G, water company, cable, telephone bill) or any bill that shows the Teaneck address.

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TEANECK PUBLIC SCHOOLS 651 Teaneck Road Teaneck, New Jersey 07666 www.teaneckschools.org

ETHNICITY AND RACE COLLECTION

In accordance with required Federal Standards [See 1997 Standards, 62 FR 58789 (October 30, 1997)], educational institutions are required to collect racial and ethnic data in the following manner:

ETHNICITY

Hispanic/Latino? (Yes or No)

Hispanic or Latino means a person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin regardless of race. The term “Spanish origin” can be used in addition to “Hispanic/Latino or Latino.”

RACE

Please select one or more races from the following five racial groups:

(1) American Indian or Alaska Native. A person having origins in any of the original peoples of North and South America (including Central America), and who maintains a tribal affiliation or community attachment.

(2) Asian. A person having origins in any of the original peoples of the Far East, South East Asia, or the Indian subcontinent including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine islands, Thailand, and Vietnam.

(3) Black or African American. A person having origins in any of the Black racial groups of Africa.

(4) Native Hawaiian or Other Pacific Islander. A person having origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands.

(5) White. A person having origins in any of the original peoples of Europe, the Middle East, or North Africa.

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TEANECK PUBLIC SCHOOLS 651 Teaneck Road Teaneck, New Jersey 07666 www.teaneckschools.org

REGISTRATION FORM FOR SCHOOL YEAR 2022-2023

TOP PORTION TO BE COMPLETED BY TEANECK PUBLIC SCHOOL PERSONNEL SKYWARD ID:	Has the student ever been enrolled in the Teaneck School system?	504
Yes	No

SA REGISTRATION DATE:	Has the student ever been enrolled in a New Jersey school system?
Yes	No	HL

REGISTRAR:

ENTRY CODE:

SE PK:

GRID CODE(ELEM/MS):	IEP:

CD Evaluation requested:
G

Evaluation requested:

GUARDIANSHIP:
Court Order submitted YES	NO

NH GUARDIANSHIP:
BOE Affidavits submitted     YES	NO	DSR

BOTTOM PORTION OF PACKET TO BE COMPLETED BY PARENT/GUARDIAN STUDENT INFORMATION

STUDENT FIRST NAME(As it appears on	STUDENT LAST NAME	MIDDLE NAME	GENDER	GRADE FOR birth certificate)                                                                                                                                                                                                  M	F           22-23 SCHOOL YEAR

STUDENT’S HOME ADDRESS	CITY

STUDENT’S MAILING ADDRESS (if different from home address)	CITY

STATE	ZIPCODE

STATE	ZIPCODE

NAME OF PARENT(S)/GUARDIAN	PRIMARY/HOME NUMBER (preferred contact number for school notifications)

PERSON ENROLLING STUDENT	TELEPHONE NUMBER	RELATIONSHIP TO STUDENT

In accordance with required Federal Standards [See 1997 Standards, 62 FR 58789 (October 30, 1997)], educational institutions are required to collect racial and ethnic data in the following manner:

Ethnicity (must check one)	Hispanic	Non-Hispanic

Race (must check one)	White	Black/African Amer	Amer Indian/Alaskan Nat	Asian	Native Hawaiian/Pacific Islander

BIRTHDATE

First Entry Date into a U.S. School: (if student is born outside of the U.S.)

AGE

Language Spoken by Child?

CITY OF BIRTH

Native Language Spoken by Child?

STATE OF BIRTH

Home Language?

COUNTRY OF BIRTH

Did student attend an ESL class in previous school?

NAME AND ADDRESS OF THE LAST SCHOOL STUDENT ATTENDED:

SCHOOL NAME:

ADDRESS:

_________________________________________________

_________________________________________________

_________________________________________________

Grade student was in PREVIOUS school: _______________________________________

Date of the last day of attendance in PREVIOUS school year: ______________________________

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TEANECK PUBLIC SCHOOLS 651 Teaneck Road Teaneck, New Jersey 07666 www.teaneckschools.org

FAMILY 1 INFORMATION – PARENT/GUARDIAN LIVING IN THE SAME HOUSEHOLD

Parent/Guardian #1 - Relationship to Student: Mother
			Father
		Legal Guardian
		Foster Parent
				
Emancipated

	
Last Name
	First Name
	Middle Name
	Title
	
Home Address
	
Primary/Home Telephone
	Cell/Alt Phone
	Email Address
	
Employer
	Work Telephone	Ext
	
		Resides With Student
		Allow Web Access

	
		
Parent/Guardian #2 - Relationship to Student: Mother
			Father
		Legal Guardian
		Foster Parent
			
Step-Parent
		DCP&P
			
Last Name
	First Name
	Middle Name
	Title
	
Home Address
	
Primary/Home Telephone
	Cell/Alt Phone
	Email Address
	
Employer
	Work Telephone	Ext
	
		Resides With Student
		Allow Web Access

FAMILY 2 INFORMATION – IF PARENT/GUARDIAN IS LIVING SEPARATELY

Parent/Guardian #1 - Relationship to Student: Mother
		Father
		Legal Guardian
		Foster Parent
	
			DCP&P
	
Last Name
	First Name
	Middle Name
	Title

Mailing Address

Primary/Home Telephone
	Cell/Alt Phone
	Email Address
	
Employer
	Work Telephone	Ext
	
		Extra Mailings
		Contact Not Allowed
		Allow Web Access
		Receive Hard Copy of Report Card

Receive email/phone notification

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TEANECK PUBLIC SCHOOLS 651 Teaneck Road Teaneck, New Jersey 07666 www.teaneckschools.org

Please list any siblings currently attending or will be attending Teaneck Public Schools

Siblings
	Grade
	Gender
	Age
	School

					

EMERGENCY CONTACT INFORMATION

First Contact
		
Name
	Phone
	Relationship
	
Second Contact
	
Name
	Phone
	Relationship
	
Third Contact
	
Name
	Phone
	Relationship

Signature of Parent/Guardian _______________________________________	Date _______________

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*****IMPORTANT****
	
PLEASE MAKE SURE TO
	INITIAL ALL THE QUESTIONS
	ON THIS FORM

TEANECK PUBLIC SCHOOLS 651 Teaneck Road Teaneck, New Jersey 07666 www.teaneckschools.org

SPECIAL SERVICES:

Has your child ever been referred for a special education evaluation? Yes	No	___________

Has your child ever been evaluated by a special education child study team? Yes	No	___________

Has your child ever been classified for special education/related services or for speech services? Yes	No	_______

Do you have any reason to suspect that your child may have a learning, emotional or physical issue? Yes	No	____

Student has an IEP (Individualized Education Program:	Yes	___________	No	___________

Parent/Guardian provided copy of IEP: Yes	No	___________

Referred by Teaneck Case Manager: Yes	No	Teaneck Case Manager Name:_________________________________

Referred to Special Services by Registrar: Yes	No	___________	If no, why?___________________________________

SPECIAL SERVICES:

Student has an ISP (Individualized Service Plan) : Yes	___________ No	___________

Parent/Guardian provided copy of ISP: Yes	No

Referred by Teaneck Case Manager: Yes	No

___________

Teaneck Case Manager Name:_______________________________

Referred to Special Services by Registrar: Yes	No	___________

SPECIAL SERVICES:

Has your child ever had a 504 Accommodation Plan: Yes	No	________

Student has a 504 Accommodation Plan:	Yes	___________	No	___________

Parent/Guardian provided copy of 504 Accommodation Plan: Yes	No	___________

Referred by Teaneck Case Manager: Yes	No	Teaneck Case Manager Name:_________________________________

Referred to Special Services by Registrar: Yes	No	___________

SPECIAL SERVICES

Early Intervention by NJ state: Yes	No

Do you have a meeting with a case manager: Yes	Date of meeting: ________________	No

Referred by Teaneck Case Manager: Yes	No	Teaneck Case Manager Name:______________________________

Referred to Special Services by Registrar: Yes	No

Parent/Guardian signature:________________________________________ Date: ___________

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TEANECK PUBLIC SCHOOLS 651 Teaneck Road Teaneck, New Jersey 07666 www.teaneckschools.org

CERTIFICATE OF RESIDENCY

I, __________________________________ hereby certify that the statements hereinafter set forth are true: (Name of parent/Legal guardian*)

I am the __________________________ of _____________________________________________________ (Father, Mother, Legal Guardian*)	(Student Name and Age)

______________________________________________________________________________________ who

is an applicant for admission to the Teaneck Public Schools.

This applicant/student resides with me and _________________________________________________________ (List all individuals with whom you reside)

____________________________________________________________________________________________

at ___________________________________________________________________ in the Township of Teaneck. (Residence address)

We have been in actual residence at this address since _______________________________________________ (Month / Day / Year)

Mark the forms of proof you are providing to demonstrate your physical address: Copy of Tax Bill or Tax Assessment Card
Copy of Deed

Copy of Current Lease Agreement Affidavit of Landlord
Copy of Utility Bill

1. Does Parent/Guardian OWN or RENT home address: _______________________________________________

2. If Mother/Father of applicant/student lives in a separate household:

Reason:	Divorced	Separated	Other:_________________________________________

Address:___________________________________________________________________________________

3. Is there a custodial court order or written agreement designating the district for school attendance?
Circle YES or NO. If yes, please submit a copy of the written agreement to this form at the time of registration.

4. Does the student reside with one parent for the entire year? Circle YES or NO. If so, with which parent at what address:_________________________________________________________________________________________

5. If the student does not reside with one parent for the entire year, explain the portion of time the student resides with each parent and at what addresses. _______________________________________________________________________________________________

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TEANECK PUBLIC SCHOOLS 651 Teaneck Road Teaneck, New Jersey 07666 www.teaneckschools.org

7. If you are claiming to be an emancipated student, are you living independently in your own permanent home in the district?

_______________________________________________________________________________________________

_______________________________________________________________________________________________

FOR YOUR INFORMATION:

I have been advised that the Board of Education of the Township of Teaneck will not accept non-resident pupils and that the following are the only exceptions permitted to the established policy:

A. Any students whose parents move out of Teaneck during a current school year may complete only the current school year provided that the proportionate tuition rate be paid in advance to the Board Secretary.
B. Students whose parents have pending arrangements for establishing residence within the district may enroll and attend school during any particular month provided that the full tuition rate for that month is paid in advance to the Board Secretary.
C. Should further time be involved in establishing residence, the parents may submit to the principal, affidavits in support of their declared plans or situation. If these are approved, the parents will be permitted to continue the attendance of their children by paying the next full monthly tuition rate in advance to the Board Secretary.

D. Longer periods of attendance beyond two calendar months must be approved by the Board of Education.

The purpose of this certificate of residency is to secure admission of said application into the Public School System of the Township of Teaneck as a resident student.

________________________________________ (Parent/Legal Guardian* Signature)

_________________________________________ TBOE Attendance Officer Initials

Registration Conditional

*Guardianship papers must be produced for examination.	Parent/Guardian: ___________________

	DISTRICT OFFICE USE ONLY

Physical verification of residency by TBOE Attendance Officer:_____________________________________

Date of verification:_____________________________________________________________________

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TEANECK PUBLIC SCHOOLS 651 Teaneck Road Teaneck, New Jersey 07666 www.teaneckschools.org

STUDENT NAME: ___________________________________ DOB:_____________ AGE:____     GRADE:_____	IEP: YES	NO

PARENT/LEGAL GUARDIAN: ___________________________________________________ PHONE: ________________________

LAST PERMANENT PLACE OF RESIDENCY IN NJ:

ADDRESS:________________________________________________________________________

CITY, STATE, ZIP CODE:____________________________________________________________

Number of years/months at last permanent address: ____________________________________

Move in date: _______________________	Move out date: _________________________

LAST SCHOOL ATTENDED: __________________________________________________________ GRADE AT LAST SCHOOL:________

LAST PERMANENT PLACE OF RESIDENCY OUT OF STATE:

ADDRESS:________________________________________________________________________

CITY, STATE, ZIP CODE:_____________________________________________________________

Number of years/months at last permanent address: ____________________________________

Move in date: ___________________________ Move out date: _____________________________

LAST SCHOOL ATTENDED: ___________________________________________________________ GRADE AT LAST SCHOOL:________

STUDENT IS PRESENTLY:	IN A SHELTER	IN A MOTEL/HOTEL	DOUBLED UP WITH FAMILY/FRIENDS	KNOWN TO DCP&P

OTHER _______________________________________

CURRENT PHYSICAL LOCATION OF STUDENT RESIDENCE: ______________________________________________ AS OF ______________

RESIDENCE STATEMENT: _______________________________________________________________________________________________

______________________________________________________________________________________________________________________

______________________________________________________________________________________________________________________

______________________________________________________________________________________________________________________

______________________________________________________________________________________________________________________

Under penalty of perjury under the laws of this state, I declare that the information provided here is true and correct and of my own personal knowledge

and that, if called upon to testify, I would be competent to do so. I also understand that I must notify the Teaneck Public School District of any changes as

soon as they occur. I give my approval for this document to be shared with the District McKinney-Vento Liaison.

Parent/Guardian signature: ________________________________Date_______________

Parent/Guardian print name: _________________________________________________

OSS: ___________________________Date_________

FOR OFFICE USE ONLY
	
ELIGIBLE UNDER MC KINNEY-VENTO:
		YES
		NO

RESIDENCY:___________________________________________________________________________________________________

DISTRICT OF RESPONSIBILITY:___________________________________________________________________________________

NOTIFICATION SENT TO:	SCHOOL PRINCIPAL	BUSINESS ADMINISTRATOR	DIRECTOR OF SPECIAL SERVICES	McK-V COUNTY LIAISON

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TEANECK PUBLIC SCHOOLS 651 Teaneck Road Teaneck, New Jersey 07666 www.teaneckschools.org

HOME LANGUAGE SURVEY Parent/Guardian Questionnaire

PLEASE PRINT

This home language survey is to be completed at the time of registration by all who are registering within the Teaneck School District. The information provided is used to determine if another language is spoken in the home. The questions should be completed by the primary caregiver (with translators available, if and when needed).

Child’s name: ____________________________________________	Date: __________ (first)	(middle)	(last)

Child's Date of Birth : ____________________________________________

Person completing the survey:	Mother	Father	Grandparent	Guardian	Other

Please tell us about your child:

1.	What language did the child learn when he/she first began to talk? __________________________

2.	What language does the family speak at home most of the time? ____________________________

3.	What language(s) does the primary caregiver (s) speak to the child most of the time? ____________

4.	What language(s) does the child speak to his/her primary caregiver (s) most of the time? _________

5.	What language(s) does the child speak to his/her brothers and sisters most of the time? __________

6.	What language does the child speak to his/her friends most of the time? _______________________

7.	In which language do you wish to receive information from the school? _______________________

8.	What name do you use for your child (if different from above)? _____________________________

Sources:
Questions 1 – 8 are based on the NJ DOE Home Language Survey that was adapted from the sample survey in A Manual for Community Representatives of the Title VI Steering Committee, published 9/76 by the Institute for Cultural Pluralism, Lau General Assistance Center, San Diego University, San Diego, CA 92182

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TEANECK PUBLIC SCHOOLS 651 Teaneck Road Teaneck, New Jersey 07666 www.teaneckschools.org

Skyward Family Access is a web-based application that allows you to track information regarding your child’s progress for the current year. You may access this program by connecting to our secured server to view assignments, attendance, report card grades, and other school information.

Skyward Family Access Parental Use and Responsibility Acknowledgement

I, _______________________________________________________________________________________, (parent/guardian name)
Parent/Guardian of

_________________________________________________________________________________________ (student name)

_________________________________________________________________________________________ (school student will be attending)

acknowledge that I have requested and received authorization to use Skyward Family Access. I understand that I share in the responsibility of keeping safe the data of my child(ren). My responsibilities include reporting any security concerns to the school district, guarding my password, changing my password on a regular basis, and promptly logging off of my Skyward Family Access session when finished or before leaving my computer. I understand that the school district may without prior notification disable my accounts as part of the overall security procedures.

_________________________________ Print Parent/Guardian Name

____________________________________ Signature of Parent/Guardian Name

Date: ____________________________

NAME OF PARENT/LEGAL GUARDIAN WHO ARE ALLOWED FAMILY ACCESS

	

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TEANECK PUBLIC SCHOOLS 651 Teaneck Road Teaneck, New Jersey 07666 www.teaneckschools.org

AFFIDAVIT OF LANDLORD

STATE OF NEW JERSEY) SS:
COUNTY OF BERGEN	)

I _____________________________________ of full age, and being duly sworn upon his or her oath, according to law, deposes and says:
1. I am the owner of property located at _____________________________________________, in the Township of Teaneck.
2. ____________________________________ is a tenant and has been a tenant at the above premises since ______________(month/day/year). A copy of this tenant’s lease, if same is in written form, is attached hereto. In the event that tenant does not have a written lease, the pertinent terms of said lease are as follows:
A. Circle one of the following: Month to Month / Year to Year B. Rental amount $ _______________ per ______________ C. The names of permissible tenants are as follows:

1. ____________________________ 2. ____________________________
3. ____________________________

4. _______________________________ 5. _______________________________
6. _______________________________

3. I am making this affidavit knowing that the Board of Education of the Township of Teaneck will rely on same in determining whether ________________________________ will be considered a pupil who is entitled to an education free of charge.

I understand that if any of the statements made by me are willfully false that I am subject to punishment.

____________________________________ (LANDLORD)
Sworn and subscribed before

me this _______ day of ________

__________________________ (A Notary Public)

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TEANECK PUBLIC SCHOOLS 651 Teaneck Road Teaneck, New Jersey 07666 www.teaneckschools.org

***IMPORTANT***

Please contact the school to schedule an appointment

Grades PreK - Kindergarten
	Grades 5-8

(PreK)
Bryant Elementary School One Tryon Avenue
David Deubel, Principal
Contact: Connie Le, Secretary - (201) 833-3976 or Venessa Watt-St. Clair, Secretary - (201) 833-5545
(K)
Theodora Smiley Lacey Elementary School One Merrison Street
Leslie Abrew King, Principal
Contact: Chanon McDuffie, Secretary - (201) 862-2508 or Yennifer Nuñez, Secretary - (201) 862-2509
	
Benjamin Franklin Middle School 1315 Taft Road
Terrence Williams, Principal Jahari Jacobs, Assistant Principal
Marina Williams Assistant Principal Catherine Hollis, Secretary - (201) 833-5451
Contact: Jennifer Henry, Guidance Secretary - (201) 833-5455

Thomas Jefferson Middle School 655 Teaneck Road Nina Odatalla, Principal
Eric Koenig, Interim Assistant Principal Ramon Ortiz, Assistant Principal
Gina Geronimo, Secretary - (201) 833-5471
Contact: Kelly McMillon, Guidance Secretary - (201) 833-5475
	
Grades 1-4
	Grades 9-12

Whittier Elementary School 491 West Englewood Avenue Piero LoGiudice, Principal
Contact: Susan DeLisio, Secretary - (201) 833-5535

Hawthorne Elementary School 201 Fycke Lane Natasha Pitt, Principal
Contact: Dawn Santamaria, Secretary - (201) 833-5540

Lowell Elementary School 1025 Lincoln Place Antoine Green, Principal
Contact: Karen Munoz - (201) 833-5550
	
Teaneck High School 100 Elizabeth Avenue
Pedro H. Valdes III, Interim Principal Margot Mack, Assistant Principal Justin O’Neill, Assistant Principal
Contact: Kim Dockery, Guidance Secretary - (201) 833-5426

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