Please include an accurate and current email address below as the school will setup your PowerSchool Parent login using this email address.



Items denoted with a red asterisk * are required.
Pendleton Heights Middle School Enrollment FastPass
 * Student's First Name:
 
Student's Middle Name:
 
 * Student's Last Name:
 
Student's Suffix:
 
 * Student's Birth Date:
 
Click to View Date Picker
 * Students Gender:
 
 * Student's Ethnicity:
 
 * Current Grade:
 
 * Does your child receive Special Ed or Speech services?
 

If Yes please list the services:
 

Example: Speech, Learning Disability, Etc.

Home Phone:
 
 -  - 
(XXX)-XXX-XXXX
 * Address:
 
Address 1
Address 2
City
State
Zip Code
 * Do you already have a Parent Portal login with South Madison Community Schools?
 


Please provide the username you use to log into Parent Portal:
 
 * Who does the child live with?
 
Mother’s/Step/Guardian1 Name:
 
Mother’s/Step/Guardian1 Email Address:
 
Please check box to receive weekly newsletters to the Mother's/Step/Guardian1 email address?
 

Father’s/Step/Guardian2 Name:
 
Father’s/Step/Guardian2 Email Address:
 
Please check box to receive weekly newsletters to the Father's/Step/Guardian2 email address?