TEANECK PUBLIC SCHOOLS 651 Teaneck Road Teaneck,New Jersey07666 www.teaneckschools.org

Date Rec'd

Grade/School

CENTRAL REGISTRATION FORMS FOR SCHOOL YEAR 2025-2026 Grades KG - 12th grade

You may submit completed registrations via email to registrar@teaneckschools.org or make an appointment to drop off completed registrations at the Board of Education Registration Office located at 651 Teaneck Road. Ifemailing–keep on the same emailchain.

Registration Office hours varyby time of year, email registrar@teaneckschools.org with any questions or to make an appointment to submit the registration in person.

For Pre-K information, contact Yamile Fernandez at 551-337-1559 or Prekregistration@teaneckschools.org

Registration Office hours are as follows:

9:00 A.M. – 3:30 P.M.
(Closed for lunch from 12:00 p.m. to 1:00 p.m.)

Completed registrations may be submitted after hours upon request.

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

CHECKLIST OF REQUIREMENTS

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

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

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.

Proof of Residency – See OPTIONS 1-4 on page 7 for list of acceptable proof of residency.

Parent/Guardian photo ID

Custodial documents if applicable.

ISP / IEP / 504 Plan – if applicable. Records Release form given by Registrar.

Name and Address of Previous School

Transcripts / Recent Report Cards - All incoming HIGH SCHOOL students' grades will be reviewed first by the Guidance Department for approval to register.

Transfer card from previous school	What is the next step?

When registration is complete at Central Office,
the school secretary will contact the parent/guardian to finish the
enrollment process.

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TEANECK PUBLIC SCHOOLS 651 Teaneck Road Teaneck,New Jersey07666 www.teaneckschools.org

Skyward Family Access Parental Use and Responsibility Acknowledgement

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.

I, 		, (parent/guardian name)

Parent/Guardian of 	

(student name)

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(Mreyn).responsibilities include reporting any security concerns to theschool 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.

x	
Print Parent/Guardian Name	Signatureof 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 Jersey07666 www.teaneckschools.org

TEANECK PUBLIC SCHOOL DISTRICT

Registration Office

651 Teaneck Road, Teaneck,

registrar@teaneckschools.org

(201) 833-5512

CONSENT TO REGISTER STUDENT

I 	certify that I am the child’s legal guardian or court (Parent/Guardian) authorized official and hereby consent for the child to be enrolled in the Teaneck Public School District.

I understand that the Teaneck Board of Education will verify the statements in this application and false statements could subject me to tuition and transportation charges.

I also understand that it is my responsibility to immediately notify the school of any changes in circumstances affecting the information set forth herein.

x	

Parent/Guardian Signature	Date

x	
Parent/Guardian Signature	Date

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TEANECK PUBLIC SCHOOLS 651 Teaneck Road Teaneck,New Jersey07666 www.teaneckschools.org

THIS GRAY PORTION FOR TEANECK PUBLIC SCHOOL PERSONNEL

SKYWARD ID:	REGISTRAR:	REGISTRATION DATE:	Supt Approval

ENTRY CODE:	SE PK:	Evaluation requested	HL

GRID CODE(ELEM/MS):	IEP:	Evaluation requested	504	Enclosed	Non Eng

GUARDIANSHIP: Court Order submitted YES	NO

GUARDIANSHIP: BOE Affidavits submitted	Disp by naturaldis. YES	NO

STUDENT INFORMATION TO BE COMPLETED BY PARENT/GUARDIAN PLEASE PRINT CLEARLY

1.! Are you claiming to be an emancipated student?! YES	NO	If yes, are you living separately. YES	No

2. Has the student ever been enrolled in the Teaneck School system? Yes	No

3.! Has the student ever been enrolled in a New Jersey school system? Yes	No

Does the student have siblings currently enrolled? If yes, please add the name and school of the student(s)

__
________________________________________________________________________________________________

STUDENTFIRSTNAME (As on birth certificate)
	STUDENT MIDDLE NAME
	STUDENT LAST NAME
	GENDER
	STUDENTGRADE FOR 2025-2026

Answer: ______
	
			M	F

STUDENT’S HOME ADDRESS
	CITY
	STATE
	ZIPCODE
	
STUDENT’S MAILING ADDRESS (if different from home address)
	CITY
	STATE
	ZIPCODE
	
NAME OF PARENT(S)/GUARDIAN
	PRIMARY/HOME NUMBER(preferredcontact number)
	
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:
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.”

Ethnicity(MUST CHECK)	Hispanic	Non-Hispanic Race(MUST CHECK) > SEE DESCRIPTIONS ON RIGHT
White	Black/African Amer	AmerIndian/AlaskanNative Asian        Native Hawaiian/Pacific Islander
	
(1) American Indian or Alaska Native. A person having origins in any of the	original	peoples     of     Noartnhd 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, SouthEast Asia, or the Indian subcontinent including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippin islands, Thailand, and Vietnam.

(3) Black or African American. A person havingorigins 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 ofHawaii, 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.

e

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TEANECK PUBLIC SCHOOLS 651 Teaneck Road Teaneck,New Jersey07666 www.teaneckschools.org

Continued from previous page

BIRTHDATE
	AGE
	CITY OF BIRTH
	STATE OF BIRTH
	COUNTRY OF BIRTH
	
First Entry Date into a U.S. School:
(if student is born outside of theU.S.)

Date needed:
	Language Spokenby Child?
	First Language SpokenbyChild?
	Home Language?
	Did studentattend anESL class in previous school?
	
				YES
		NO

NAME AND ADDRESS OF LAST SCHOOL STUDENT ATTENDED

SCHOOL NAME: 	

ADDRESS: 	

CITY/STATE	
	
GRADESTUDENTWASIN PREVIOUS SCHOOL:

DATE OF LAST DAY OF ATTENDANCEINPREVIOUS SCHOOL:

FAMILY1INFORMATION > PARENT/GUARDIAN LIVING IN THE SAME HOUSEHOLD

PARENT/GUARDIAN 1- Relationship to Student: Mother
			Fath ated
	er
		Legal Guardian
		Foster Parent
			
Emancip

First Name
	Middle Name
	Last Name
	Title (Mr. Mrs. Ms. Dr.)
	
Home Address
	
Primary/HomeTelephone
	Cell/Alt Phone
	Email Address (PRINT CLEARLY)
	
Employer
	Work Telephone	Ext
	
		ResidesWith Student
		AllowWeb Access

	
	
PARENT/GUARDIAN 2- Relationship to Student: Mother
		Father
		Legal Guardian
		Foster Parent
			
Step-Parent
		DCP&P
			
First Name
	Middle Name
	Last Name
	Title (Mr. Mrs. Ms. Dr.)
	
Home Address
	
Primary/HomeTelephone
	Cell/Alt Phone
	Email Address (PRINT CLEARLY)
	
Employer
	Work Telephone	Ext
	
		ResidesWith Student
		AllowWeb Access

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TEANECK PUBLIC SCHOOLS 651 Teaneck Road Teaneck,New Jersey07666 www.teaneckschools.org

IF PARENT/GUARDIAN IS LIVING SEPARATELY FROM FAMILY 1

FAMILY2 INFORMATION
Parent/Guardian #1 - Relationship to Student: Mother
		Father
		Legal Guardian
		Foster Parent
	
			DCP&P
	
First Name
	Middle Name
	Last Name
	Title (Mr. Mrs. Ms. Dr.)

Mailing Address

Primary/HomeTelephone
	Cell/Alt Phone
	Email (PRINT CLEARLY)
	
Employer
	Work Telephone	Ext

Extra Mailings	Contact Not Allowed	AllowWeb Access	Receive Hard Copy of Report Card

Receive email/phone notification

Please list any siblings that will also be registered now into the 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

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TEANECK PUBLIC SCHOOLS 651 Teaneck Road Teaneck,New Jersey07666 www.teaneckschools.org

Mark the forms of proof you are providing to demonstrate your physical address. Please check
Copyof Tax Bill, Tax Assessment Card, or Recent Mortgage Statement and utilitybill Copy of Deed and utility bill
Copyof Current Lease Agreement and utility bill Affidavit of Landlord – see option 3 or 4 below

1. Does Parent/Guardian OWN	RENT	Living/renting with someone who owns

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?

YES	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? YES parent at what address:

NO	If so, with which

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.

	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 recentutilitybill(i.e.PSE&G,watercompany,cable, telephone bill).

OPTION 3: IF YOU RENT AND DO NOT HAVE 
A LEASE
1. You must have the owner/landlord of the prop 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 copyof 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
e 1. You must have the owner/landlord of the property complete an Affidavit of Landlord form. The owner of theproperty must sign the form and have it notarized. You do not
need to disclose anyrent 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 boillr) any bill that shows the Teaneck address.

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TEANECK PUBLIC SCHOOLS 651 Teaneck Road Teaneck,New Jersey07666 www.teaneckschools.org

AFFIDAVIT OF LANDLORD (for option 3 or 4 previous page)

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.	4. 	

2.	5. 	

3.	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 Jersey07666 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 AMOTEL/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 todo so. I also understand that I must notify the Teaneck Public School District of any changes

as soon as they occur. I givemy approval for this document to be shared with the DistrictMcKinney-Vento Liaison.

Parent/Guardiansignature:X	Date X	

Parent/Guardian print name: 	

FOR OFFICE USE ONLY

ELIGIBLE UNDER MC KINNEY-VENTO:	YES	NO

OSS: 	Date	

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 Jersey07666 www.teaneckschools.org

HOME LANGUAGE SURVEY Parent/Guardian Questionnaire

P L E A S E P R I N T

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 primarycaregiver (s) speak to the child most of the time? 	

4.	What language(s) does the child speak to his/her primarycaregiver (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 theNJ 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 Jersey07666 www.teaneckschools.org

CHECK THE ANSWER AND INITIAL ALL QUESTIONS ON THE LINE AFTER

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 anyreason to suspect that your child mayhave 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	TeaneckCaseManager

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

EarlyIntervention byNJ 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: x	Date: 	

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TEANECK PUBLIC SCHOOLS
Central Administration Office - Transportation Department 651 Teaneck Road Teaneck, New Jersey 07666 Phone (201) 833-5505

Transportation@teaneckschools.org
________________________________________________________________________________________________________________

Transportation Request Form

State law requires that transportation be provided as follows:

• Pupils in grades K-8 who live more than 2 miles from school;
• Pupils in grades 9-12 who live more than 2.5 miles from school; • Special education students with a valid IEP

Courtesy Busing
Courtesy busing is provided for students in grades preschool (Pre-K) through the fourth (4th) grade that reside more than 1.3 miles from their school of attendance. Children who live within walking distance of their school may not use the school buses at any time.
Parents/guardians are responsible for walking their children to and from the bus stop. If you cannot meet your child in the afternoon, we recommend that you arrange for someone to meet your child at the bus stop.

Exclusions
Courtesy busing does not apply to students in middle school and high school or preschool at Bergen Day and The Early Learning Center.

Student Information

School Year __________________________________________

Student’s Name ________________________________________

Grade _____________________________________________

School _____________________________________________

House Address ______________________________________________________________________________________________________

Home Phone____________________________________________ Cell______________________________________________

Parent/Guardian Transportation Preference

Morning:	Afternoon:	Both:

Parent/Guardian Signature:_____________________________________________________	Date: _______________________________

Note: You may not be eligible based on distance from your residency to school. Changes take at least 3 – 4 business days.

Application Status

Qualifies For Busing	Does Not Qualify for bus:	Subscription Busing Request:	 Transportation Start Date: ______________________________

Bus # __________________	Bus Stop: ____________________________________________________________________________

Parent/Guardian Notified (date): ____________________________________________

TEANECK BOARD OF EDUCATION

Andre D. Spencer, Ed.D. Superintendent of Schools Superintendent@teaneckschools.org

Shellian Mirander
Director of Special Education & Nursing Services, Elementary Education Smirander@teaneckschools.org

TEANECK PUBLIC SCHOOLS School Health Services Requirements

Dear Parents/Guardians,

In order to complete your child’s registration to attend school, you must provide proof of the following:

★ PHYSICAL EXAMINATION

· A physical examination within 365 days prior to admission to school, or within 30 days of admission to school is REQUIRED

· Testing for Tuberculosis (TB) may be required if you are entering from out of the country.

· The Physical Examination should be on the Teaneck Physical Examination Form or the Universal Health Form that includes the same information.

· Your child’s Healthcare Provider MUST sign and stamp the form and indicate whether your child is cleared for all activities or indicate restriction to activities.

· The Healthcare Provider should also list any allergies, medications or other health concerns such as asthma, diabetes, and seizure history.

★ IMMUNIZATIONS

· Immunizations must be up to date as per New Jersey State Requirements

· It must be an OFFICIAL document transcribed in English

Thank you in advance for your cooperation. We look forward to serving your child in a healthy environment at school.

Respectfully,

Teaneck School Nurses

TEANECK PUBLIC SCHOOLS MEDICAL DEPARTMENT
PHYSICIAL EXAMINATION

Name: _________________________ Age: ______ Date of Birth: _________ Home Phone: ______________ Address: __________________________________ City/State/Zip: ___________________________________ School: ________________________ Grade: _____________________ Sex: ___________________________ Physician: ______________________ Phone: _____________________ Fax Number: ____________________ Address: __________________________________ City/State/Zip: ___________________________________

PHYSICIAN OR PROVIDER INFORMATION – PLEASE COMPLETE BOTH PAGES

Exam Date: ________	Height: _______ Weight: ________ Blood Pressure: ____/____ Pulse: ____ bpm.

Vision: R 20/ ____ L 20/ ____ Corrected: Y N	Contacts: Y N	Glasses: Y N Hearing: _______

	Normal
	Abnormal Findings
	Comments
	
General Appearance
				
Head/Neck
				
Eye/Sclera/Pupils
				
Ears
				
Gross Hearing
				
Nose/Mouth/Throat
				
Lymph Glands
				
Heart: Murmurs/Rhythms
				
Lungs: Auscultation/Percussion
				
Chest Contour
				
Skin
				
Abdomen:
Assessment (inc. liver, spleen)
				
Tanner Stage: Testes/Onset of Menses
				
Hernia
	Absent
			
Neck/Back/Spin: Range of Motion
				
Scoliosis
	Absent
			
Upper Extremities
				
Lower Extremities
				
Neurological:
Balance & Coordination Romberg:
				
Evidence of Marfan Syndrome
	Absent

Most recent Immunizations/Dates: _____________________________________________________________ Medications currently in use: __________________________________________________________________ Additional Observations/comments: ____________________________________________________________ __________________________________________________________________________________________

Continued on back page

HISTORY: Please complete all areas where disease or alterations have occurred and explain below.
_____ Allergies/Anaphylaxis	_____ Eczema/Skin	_____ Hospitalizations/Surgery _____ Asthma/Respiratory	_____ Endocrine	_____ Musculoskeletal
_____ Cardiovascular/Murmur	_____ Gastrointestinal	_____ Neurological/Seizures _____ Childhood diseases	_____ Genitourinary	_____ Other
Explanation/Comments: ________________________________________________________________________________________ ____________________________________________________________________________________________________________

CLEARANCE:
A. Student may participate in physical education and all sports:	Yes ____	No ____	Date: ____________________ B. Cleared after completing evaluation for: _________________________________________________________________ C. NOT CLEARED FOR: Collision ________	Contact _______                    Non-Contact _________
Strenuous _______	Moderate ______	Non-Strenuous _______ Diagnosis: ____________________________________________________________________________________ Recommendations: _____________________________________________________________________________

EXAMINED BY: Physician’s/Provider’s Stamp:
Family Physician/ Provider: School Physician:
License Type:
MD/DO APN
PA

Physician’s/Provider’s Signature: ________________________________________ Today’s Date: __________

VACCINE
	TOTAL #DOSES
	DATE
	DATE
	DATE
	DATE
	DATE
	
DPT/DTaP
							
Tdap
							
OPV
							
IPV
							
MMR
							
Measles
							
Mumps
							
Rubella
							
Hepatitis B
							
HIB / Prohibit
							
Varicella
							
Pneumococcal (PCV7)
							
Meningococcal
							
RSV
							
Gardisil

Lead: Date Performed: ____________	Record Value _____________ Tuberculosis Testing
Mantoux tests:	Date: ______ Result: ______	Date: ______ Result: _________ Chest x-ray	Date: ______Result: _____________________________________ INH Therapy: Date Started: __________ Dosage: ____________ How Long: _________

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

***IMPORTANT***

The school’s secretary will contact the parent/guardian to schedule an appointment to finish the enrollment.

Grades PreK - Kindergarten
	Grades 5-8

(PreK)
Bryant Elementary School
One Tryon Avenue David Deubel, Principal
Contact: Antonia Hernandez - (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 (201) 862-2509
	
Benjamin Franklin Middle School 1315 Taft Road
Terrence Williams, Principal Jahari Jacobs, Assistant Principal
Gulshir Khan, Secretary - (201) 833-5451
Contact: Jennifer Henry, Guidance Secretary - (201) 833-5455

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

Whittier Elementary School 491 West Englewood Avenue Debra Nussbaum, Principal
Contact: Tracey Strand-Coley, Secretary -201-833-5535
Hawthorne Elementary School 201 Fycke Lane
Emilio Jeanette, Principal
Contact: Dawn Santamaria, Secretary - (201)833-5540

Lowell Elementary School 1025 Lincoln Place
Pedro Valdes, Principal
Contact: Karen Munoz, Secretary - (201) 833-5550
	
Teaneck High School 100 Elizabeth Avenue Piero LoGiudice, Principal
Margot Mack, Assistant Principal Justin O’Neill, Assistant Principal
Contact: Greg Castro, Guidance Secretary - (201) 833-5426

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