Register for On-line Access
iPass
Improving K-12 Education Through Software
2020-2021
Please register all students at the same time.
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Personal Information
Title:
Mr.
Mrs.
Ms.
Miss
Dr.
Gender:
Female
Male
*
First Name:
Middle Name:
*
Last Name:
*
Email:
Workplace:
*
indicates a required field.
Address Information
Type:
Home
Mailing
Other
Student
Summer
Work
Street No:
Street Name:
Apt
Address 2:
City:
State:
.
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illnois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
Washington D.C.
West Virginia
Wisconsin
Wyoming
Zip Code
Telephone Numbers
*
Phone:
Ext:
Type:
AUNT
BEEPER
BROTHER
CELL NUMBER
EMERG. CONTACT CELL PHONE
EMERG. CONTACT PAGER
EMERGENCY CONTACT
FATHER
FATHER ( WORK)
FATHER (CELL PHONE)
FATHER (PAGER)
FRIEND
GRANDPARENT
GRANDPARENT (WORK)
GUARDIAN
HOME PHONE
HOME/CELL
MOTHER
MOTHER & FATHER @ WORK
MOTHER ( PAGER )
MOTHER ( WORK )
MOTHER (CELL)
NEIGHBOR
PAGER
SISTER
STEPFATHER ( WORK )
STEPFATHER (CELL)
STEPMOTHER ( WORK )
STEPMOTHER (CELL)
STUDENT CELL
UNCLE
UNLISTED OR UNPUBLISHED
WORK
Rank:
1
2
3
4
e.g. 999-999-9999
Phone:
Ext:
Type:
AUNT
BEEPER
BROTHER
CELL NUMBER
EMERG. CONTACT CELL PHONE
EMERG. CONTACT PAGER
EMERGENCY CONTACT
FATHER
FATHER ( WORK)
FATHER (CELL PHONE)
FATHER (PAGER)
FRIEND
GRANDPARENT
GRANDPARENT (WORK)
GUARDIAN
HOME PHONE
HOME/CELL
MOTHER
MOTHER & FATHER @ WORK
MOTHER ( PAGER )
MOTHER ( WORK )
MOTHER (CELL)
NEIGHBOR
PAGER
SISTER
STEPFATHER ( WORK )
STEPFATHER (CELL)
STEPMOTHER ( WORK )
STEPMOTHER (CELL)
STUDENT CELL
UNCLE
UNLISTED OR UNPUBLISHED
WORK
Rank:
1
2
3
4
Phone:
Ext:
Type:
AUNT
BEEPER
BROTHER
CELL NUMBER
EMERG. CONTACT CELL PHONE
EMERG. CONTACT PAGER
EMERGENCY CONTACT
FATHER
FATHER ( WORK)
FATHER (CELL PHONE)
FATHER (PAGER)
FRIEND
GRANDPARENT
GRANDPARENT (WORK)
GUARDIAN
HOME PHONE
HOME/CELL
MOTHER
MOTHER & FATHER @ WORK
MOTHER ( PAGER )
MOTHER ( WORK )
MOTHER (CELL)
NEIGHBOR
PAGER
SISTER
STEPFATHER ( WORK )
STEPFATHER (CELL)
STEPMOTHER ( WORK )
STEPMOTHER (CELL)
STUDENT CELL
UNCLE
UNLISTED OR UNPUBLISHED
WORK
Rank:
1
2
3
4
Phone:
Ext:
Type:
AUNT
BEEPER
BROTHER
CELL NUMBER
EMERG. CONTACT CELL PHONE
EMERG. CONTACT PAGER
EMERGENCY CONTACT
FATHER
FATHER ( WORK)
FATHER (CELL PHONE)
FATHER (PAGER)
FRIEND
GRANDPARENT
GRANDPARENT (WORK)
GUARDIAN
HOME PHONE
HOME/CELL
MOTHER
MOTHER & FATHER @ WORK
MOTHER ( PAGER )
MOTHER ( WORK )
MOTHER (CELL)
NEIGHBOR
PAGER
SISTER
STEPFATHER ( WORK )
STEPFATHER (CELL)
STEPMOTHER ( WORK )
STEPMOTHER (CELL)
STUDENT CELL
UNCLE
UNLISTED OR UNPUBLISHED
WORK
Rank:
1
2
3
4
Internet User Information
*
User ID:
The Password must be at least 6 characters long.
*
Password:
*
Verify Password:
Primary Student Information
*
Student ID:
*
First Name:
Middle Name:
*
Last Name:
*
DOB:
e.g. mm/dd/yyyy
City of birth:
Student lives with me.
Relationship to Student:
Please select relationship
Emergency Contact
Father
Guardian
Mother
Other
State Ward
Stepfather
Stepmother
Temporary Guardian
Additional Student 2
*
Student ID:
*
First Name:
Middle Name:
*
Last Name:
*
DOB:
e.g. mm/dd/yyyy
City of birth:
Student lives with me.
Relationship to Student:
Please select relationship
Emergency Contact
Father
Guardian
Mother
Other
State Ward
Stepfather
Stepmother
Temporary Guardian
Additional Student 3
*
Student ID:
*
First Name:
Middle Name:
*
Last Name:
*
DOB:
e.g. mm/dd/yyyy
City of birth:
Student lives with me.
Relationship to Student:
Please select relationship
Emergency Contact
Father
Guardian
Mother
Other
State Ward
Stepfather
Stepmother
Temporary Guardian
Additional Student 4
*
Student ID:
*
First Name:
Middle Name:
*
Last Name:
*
DOB:
e.g. mm/dd/yyyy
City of birth:
Student lives with me.
Relationship to Student:
Please select relationship
Emergency Contact
Father
Guardian
Mother
Other
State Ward
Stepfather
Stepmother
Temporary Guardian
Additional Student 5
*
Student ID:
*
First Name:
Middle Name:
*
Last Name:
*
DOB:
e.g. mm/dd/yyyy
City of birth:
Student lives with me.
Relationship to Student:
Please select relationship
Emergency Contact
Father
Guardian
Mother
Other
State Ward
Stepfather
Stepmother
Temporary Guardian
Additional Student 6
*
Student ID:
*
First Name:
Middle Name:
*
Last Name:
*
DOB:
e.g. mm/dd/yyyy
City of birth:
Student lives with me.
Relationship to Student:
Please select relationship
Emergency Contact
Father
Guardian
Mother
Other
State Ward
Stepfather
Stepmother
Temporary Guardian
Additional Student 7
*
Student ID:
*
First Name:
Middle Name:
*
Last Name:
*
DOB:
e.g. mm/dd/yyyy
City of birth:
Student lives with me.
Relationship to Student:
Please select relationship
Emergency Contact
Father
Guardian
Mother
Other
State Ward
Stepfather
Stepmother
Temporary Guardian
Additional Student 8
*
Student ID:
*
First Name:
Middle Name:
*
Last Name:
*
DOB:
e.g. mm/dd/yyyy
City of birth:
Student lives with me.
Relationship to Student:
Please select relationship
Emergency Contact
Father
Guardian
Mother
Other
State Ward
Stepfather
Stepmother
Temporary Guardian
Additional Student 9
*
Student ID:
*
First Name:
Middle Name:
*
Last Name:
*
DOB:
e.g. mm/dd/yyyy
City of birth:
Student lives with me.
Relationship to Student:
Please select relationship
Emergency Contact
Father
Guardian
Mother
Other
State Ward
Stepfather
Stepmother
Temporary Guardian
Additional Student 10
*
Student ID:
*
First Name:
Middle Name:
*
Last Name:
*
DOB:
e.g. mm/dd/yyyy
City of birth:
Student lives with me.
Relationship to Student:
Please select relationship
Emergency Contact
Father
Guardian
Mother
Other
State Ward
Stepfather
Stepmother
Temporary Guardian
