Complete Enrollment Packet


Now that you have been invited to enroll at Taos Academy Charter School your family must complete the following enrollment forms. Before you start please understand the following:

1. If you leave your form in progress open for longer than 20 minutes you are likely to lose your data.
2. The entire form must be completed in one sitting to be submitted, you can not save your work to return later.
3. In order to complete the form you should have on hand your child's medical insurance and healthcare provider contact information and have access to information about the last school your child attended (including address, phone, and fax).

Taos Academy Enrollment Packet

Welcome to Taos Academy. Please provide us with the following important enrollment information to assure that your family quickly and easily becomes a part of the Taos Academy family.

Please carefully and thoroughly complete and digitally sign and submit the following online form. If you do not agree to sign a single authorization to all requests contained within or have a problem with completing these forms online, please contact Taos Academy to request a paper packet. 

Once you compete the following web form you will need to submit additional required enrollment documents to school staff. Detailed instruction on the necessary documents can be found: 1. at the end of this form, 2. in the post submission message and 3. in the enrollment form receipt that will be emailed to you upon submission.

Please complete the entire document before submitting. Partial submissions will be discarded and you will be asked to resubmit.


Today's Date:  

Student ID Number (if known):   

First Name:  Last Name:  

Middle Name:  Nickname: 

Date of Birth:  Birth City:  

Birth State:  Curent Grade:​  

Mailing Address:  

City:  State:  Zip Code:        

Physical Address:  

City:  State:  Zipcode: 

Last Educational Program Attended:   

If "Other" please list: 

Ethnicity: Hispanic? 




Guardian 1 First Name:  Last Name:  

Relationship:  Lives with student?  Yes  No  

Home Phone: Cell Phone:  

Daytime Phone:   Email: 


Guardian 2 First Name:  Last Name:  

Relationship:  Lives with student?  Yes   No  

Home Phone:   Cell Phone:  

Daytime Phone:  Email: 


Guardian 3 First Name:  Last Name:  

Relationship:  Lives with student?  Yes  No  

Home Phone:   Cell Phone:  

Daytime Phone:  Email: 


Guardian 4 First Name:   Last Name:  

Relationship:  Lives with student?  Yes  No  

Home Phone:  Cell Phone:  

Daytime Phone:   Email: 


Guardian 5 First Name:  Last Name:  

Relationship:  Lives with student?  Yes  No  

Home Phone:   Cell Phone:  

Daytime Phone:  Email: 



Local people to contact if parents cannot be reached

Emergency Contact 1: First Name:  Last Name:  

Relationship?  Best Phone:  


Emergency Contact 2: First Name:  Last Name:  

Relationship?  Best Phone:  


Please list the full names of people who are authorized to pick up your children from school: 


Which modes of transportation should we expect your family to utilize? Check all that apply.

Walk     Bike     Car Transport     Public Transport     Student is a Driver (must show valid license and proof of auto insurance and receive parking pass authorization to drive to/from school)


Does student have current IEP?

Yes No  I don't know

Does student have current 504 Plan/Medical Diagnosis?

Yes No I don't know



Does student have current medical insurance? 


Insurance Carrier:    Subscriber ID:  


(In acordance with the "No Child Left Behind ACT, Title I, Part A, Section 1111" and New Mexico Public School Code 22-10A-16) Parents' Right to Know)

The federal, No Child Left Behind, and the State, Public School Code permits you as a parent, the right to request information about the licensure and other qualifications, teaching assignment, and training of your child's teacher, instructional support providers, including paraprofessionals, and school principal who may work with your child.

If you are interested in requesting this information, please contact: MichelleDeHerrera (575) 751-3109



Purpose: To enable parents or guardians to AUTHORIZE emergency treatment for children who become ill or injured while under school authority, when parents cannot be reached. Upon completion, parents must return this form to the school. The orginal form and any copies therof may be used to identify the medical options of the undersigned parent.


Please indicate if student has ever had or is currently under treatment for any of the following conditions by selecting the check boxes to the left of the condition. For all selected please include a short explanation (Hepatits or Diabetes type, Severity of Asthma or Seizures, and date or age diagnosed, and if applicable date released from care).

 Asthma Diabetes Ear/Hearing Problems 
 Eye/Vision Problems Emotional Problems    Seizures  
 Heart Problems Hepatitis  Allergies   
 Reactions to Medication/Injection  Muscular Weakness /Paralysis   Bleeding Disorders 
 High Blood Pressure Infectious Diseases Meningitis 
Migraine HeadacheNone Known 


Please give further explanation of any conditions selected above including dates, procedures, diagnoses, current treatments, medications, and any other factors to which you feel the school should be alerted. 

Has the student ever (check all that apply):

Been hospitalized for Serious Illness or Accident?  Yes  No  

Been on Long Term Medication?   Yes   No

Been informed of the need to be on Antibiotic Therapy prior to dental treatment? Yes  No 

If selected please state which therapy? 

Received a recent Tetanus Shot? Yes No

Date Tetanus received: 

Please list any Medical History or Condition not covered above:



In case of an emergency involving my child where I cannot be reached, I hereby give consent to transport my child to the following medical care providers and hospital, and authorize these providers and hospital to give any reasonable and customary medical and health care deemed necessary.

Please provide information about your preferred emergency medical contacts:

Doctor Information: Name:  Phone:    

Dentist Information: Name:  Phone:  

Nurse or Physician Information: Name:  Phone: 

Hospital Information: Name:  Phone: 

If, for any reason, the above listed medical care providers or hopital cannot be reached, I authorize appropriate transport and medical care of my child to any appropriate medical care provider, hospital or medical facility. This authorization does not cover major surgery unless one other doctor/dentist concurs to the need.

Nothing in this section shall be construed to impose liability on any school official or school employee who, in good faith, attempts to comply with section. It is understood that I will be financially responsible for all emergency care.

Please give your consent with your digital signature (Initial here): 


"I've Got a Great Idea! Let's Get E-Rate Funds for our School"

We need everyone to complete this survey in order for it to be considered valid and to result in rate reductions on purchases of school technology hardware and software. Please complete this part of the form even if your family does not meet the Income Eligibility Guidelines.

*This information will be kept confidential and will be reported only as a total group, not by individual family, and will not be used for any purpose other than E-Rate eligibility determination.

Number of people living in student's household (including student) 

Annual gross household income is less than or equal to

Please check all that apply for anyone living in same household as student:

 Does your family qualify for medical assistance under Medicaid?

 Do you receive Supplementary Security Income? (SSI)

 Does your family receive housing assistance? (HUD)

 Does your family receive home energy assistance? (LIHEAP)

 Does your family receive Temporary Assistance for Needy Families? (TANF)

 Does your family receive Food Distribution on Indian Reservations? (FDPIR)

 Is someone in Foster Care? (requires CYFD documentation)

 Is someone a Migrant? (requires NM Certificate of Eligibility on file)

 Is someone homeless? (requires Charter Liason documentation)

 If you are unsure of the answers to the above questions please select this button and someone from the school will contact you to help you complete this section of the form.


The following activities are beneficial to the educatioanl process of my child identified below, having the legal authority to do so, I hereby grant permission to Taos Academy Charter School to release information about my child in connection with the following education related activities checked below.

 Inclusion in the Honor Roll and publication of the sutdent's name as part of the Honor Roll and/or other honors publically bestowed on the student in any print or broadcast medium for the purpose of recognizing the named student's academic achievements. Such recognition may include publication of the criteria for Honor Roll inclusion such as name and grade point average.

 Public display of student artwork and other related material, which may bear any award, grade earned and the student' s name.

 Publication of student’s photograph, video and audio recordings, likeness, artwork, profile, and/or story for publications, webpages and other promotional materials representing Taos Academy.

 Publication of student/parent contact information in school directory. i.e. phone and email address

 Students may participate in cooperative or group projects and receve a group grade, as well as an individual grade based on specific rubric. Group-graded exercises in which student may critique other sutdent's assignments. These activities promote peer learning and peer teaching.

 Identification in written or oral recommendations of the student by an employee.

 I also understand that this grant of permission shall only be revoked by written insturment delivered to the Director of the school. This content shall remain in effect while my child is enrolled at Taos Academy, unless revoked.

Please give your consent with your digital signature (Initial here): 


Our bilingual program requires that we do a survey of languages spoken. To better serve the needs of our students, we need your cooperation in answering the following questions.

1. What language or languages are spoken at home? 

2. What language or languages are spoken in a family or close friend's home where your child spends significant time? 

3. What was the first language spoken by you, the parents, caretakers or guardians, when you were children? 

4. What language or languanges does your child understand? 

5. What language or languages does your child speak at home? 

6. What language or languages does your child read at home? 

7. What languages does your child write at home? 

If you answered Other to any of the language questions please let us know which other Language(s) your child speaks, understands, reads, writes. 


We are pleased to note that Taos Academy students will be able to access the computer network on a regular basis for electronic e-mail and the Internet. To gain access to e-mail and the Internet all students under the age of 18 must receive parental permission below. Over 18 must sign for themselves.

The following practices during electronic mail and the Internet access shall be prohibited:

  • Any use for political or commercial purposes 
  • The use of electronic mail in any matter that is contrary to school policy
  • Any use of profanity or inappropriate language on electronic mail
  • Any use that disrupts the educational and administrative goals of the school
  • Any use of the account by anyone but the authorized owner of the account
  • Any reproduction of copyrighted material without explicit permission
  • Access of material that has been deemed inappropriate for school use
  • Using obscene language 
  • Sending or receiving offensive messages or pictures 
  • Harassing, insulting, or attacking others 
  • Damaging computers, computer systems, or computer networks 
  • Using another's password
  • Trespassing on another's folders, work or files

Violations may result in loss of access as well as other disciplinary or legal action. SEE TACS POLICY HANDBOOK FOR MORE INFORMATION

Staff and students will be allowed access to Internet resources with the understanding that some material that can be accessed on the Internet in inaccurate; additionally, some resources contain material that is deemed contrary to prevailing community standards and is inappropriate for classroom use, and that access of such resources will not be permitted.

The school will provide a computer interface to Internet services that students should use in accessing instructional and reference material on the Internet. This interface will be designed so that objectionable materials are not easily available (for example Cyber Patrol to filter objectionable material); however, the Internet is designed in such a manner that all material contained within it are accessible using various search and retrieval tools. Students and parents must be informed that if inappropriate material is inadvertently encountered, it shall be disengaged from immediately. Students and teachers must be insturcted in the necessary procedures of evaluation of information and resources as part of their ongoing education for life in modern society. 


As a user of the Taos Academy computer network, I hereby agree to comply with the above stated rules regarding communications over the network in a reliable fashion while honoring all relevant laws and restrictions.

Student Signature: (initial here) 

Parent Signature or Student Signature if over 18: (initial here and above) 


I, (parent) , agree to have my child academically tested by Taos Academy staff at Taos Academy for appropriate placement into content courses prior to school opening.

I (parent) , will assure that my child, registered at Taos Academy, will be in attendance at the school to take all curricular and state mandated tests on the scheduled dates as stated in the Taos Academy Charter School Calendar.

I (student) , registered as a student will be in attendance at the school to take all curricular and state mandated tests on the scheduled dates as stated in the Taos Academy Charter School Calendar. 

Student Signature:(initial here) 

Parent Signature: (initial here) 


Parental Commitment:

In signing below, I agree to provide daily support to assist my child in succeeding in this program. I undersand that it takes a considerable amount of motivation and commitment on the part of the student as well as the parent and I am willing to provide support to my student in the following ways:

  • Develop a home study area/office for the student set apart from daily distractions.

  • Provide an up to date computer with high speed internet access.

  • Help support an academic work schedule and good time management skills.

  • Check and monitor progress towards semester goals at least weekly. 

  • Transport to school and leadership activities in a timely manner. 

  • Provide a healthy lunch and snack for school and activity days. 

  • Participate in two Taos Academy school events, including the Sweet Slide annual fundraiser.

  • Encourage and inspire student throughout the program towards accomlishing all educational goals. 

  • Work with the student's advisor to develop and maintain a learning program that is aligned to the student's interestes and educational goals. 

  • Read and review the Taos Academy Handbook annually with your student.

Student Commitment:

I agree to work a minimum of 20 hours a week in the online curriculum and in the 21st Century programming to ensure I am staying on track with my educational goals. I agree to attend my leadership classes as scheduled within or outside of the school building. I will ask for help when I need it and check my progress daily. I agree to work with my advisor to develop a 21st Century Learning Program that fits my interest and is aligned to my educational goals. I agree to abide by the rules and policies of the Taos Academy Handbook at all times when on campus or when on a school sponsored activity off campus.

Student Signature: (initial here) 

Parent Signature: (initial here) 


Please check activities of interest to parents and family members:

 Parent Advisory Council 

 Volunteer for Activities and Field Trips (chaperone, planning, etc)


Please include other interests or ideas here:




Every resonable precaution will be taken to provide for the safety and care of the student. In the event of an accident requiring emergency care, necessary arrangements will be made. However, parents must assume financial reponsibility.

I, the parent or guardian give permission for my child to participate in walking field trips away from Taos Academy Charter School for the current school year with the supervision of Taos Academy Staff.

Possible trips include:

  • UNM Taos
  • Baca Park
  • Kit Carson Park
  • Kit Carson Museum
  • Taos Plaza
  • Albertson's Shopping Center
  • Harwood Museum
  • Taos Public Library
  • Taos Youth and Family Center
  • TCEDC - Taos County Economic Development Corporation
  • Taos Art Museum
  • Taos Center for Martial Arts
  • Taos Eco Park
  • Taos Roc Pit Disc Golf Park
  • Mineral and Fossil Gallery
  • Blumenschein Home and Museum
  • Governor Bent Museum
  • Taos Community Auditorium
  • Taos Town Hall
  • Taos Civic Plaza
  • Taos Village Farm
  • Filemon Sanchez Park
  • Rocky Mountain Youth Corps Ropes Course
  • Leadership Days Destinations (not walking field trip)
  • Other destinations within walking distance.

I understand that all Taos Academy Charter School policies and procedures will be enforced during school-sponsored activities.

Student Signature:(initial here) 

Parent Signature: (initial here) 


The following need only be completed if your family considers itself a member of a native american tribe, band or group:


Elementary and Secondary Education Act, Title VII, Part A, Subpart 1

In order to apply for a formula grant under the Indian Education Program, your child's school must determine the number of Indian children enrolled. Any child who meets the following definition may be counted for this purpose. You are not required to complete or submit this form to the school. However, if you choose not to submit a form the school cannot count your child for funding under the program. This form will become part of your child's school record and will not need to be completed every year. This form will be maintained at the school and information on the form will not be released without your written approval.

Definition: Indian means any individual who is (1) a member (as defined by the Indian tribe or band) of an Indian tribe or band including those Indian tribe or bands terminated since 1940, and those recognized by the State in which the tribe or band reside; or (2) a descendent in the first or second degree (parent or grandparent ) as described in (1); or (3) considered by the Secretay of the Interior to be and Indian for any purpose; Or (4) an Eskimo or Aleut Native; or (5) a member of an organized Indian group that received a grant under the Indian Education Act of 1988 as it was in effect October 19, 1994. 


Tribe, band or group is 

Name of Individual with Tribal Membership 

Individual Named is 

Proof of membership as defined by tribe, band or group is (include membership or enrollment number if available, OR please explain other proof of membership:


Name and address of organization maintaining membership data for the tribe, band or group: 

I verify that the information provided above is accurate.

Parent Signature: (initial here) 

PAPERWORK BURDEN STATEMENT: According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless such collection displays a valid OMB control number. The valid OMB control number for this information collection is 1810-0021. The time required to complete this protion of the information collection per type of respondent is estimated to average: 15 minutes per Indian student certification (ED 506) form; including the time to review instructions, search existing resources, gather the data needed, and complete and review the information collection. If you have any comments concerning the accuracy of the time estimate(s) or suggestions for improving this form, please write to: U.S. Department of Education, Washington, D.C. 20202-4651. If you have comments or concerns regarding the status of your individual submission of this form, write directly to: Office of Indian Education, U.S. Department of Education, 400 Maryland Avenue, S.W., LBJ/Room 3E200, Washington D.C. 20202-6335.


Taos Lions Club, PO Box 199, Taos, NM 87571 

Lions Contact: Gary Vest 575-770-7729

Organization/ School Contact: Ann Marie Arguello

Has your child been seen by and eye professional in the last year?  

Does your child wear corrective lenses?  

Child's Insurance: 

Your Lions Club in cooperation with Taos Academy Charter High School is providing a free vision screening.

Your child is eligible to have a state-of-the-art digital image taken for evaluation to determine if your child should be tested further by and eye specialist of your choice.

The photo screening and evaluation may determine the presence of eye disorders, including far and near sightedness, astigmatism, strabismus (misaligned eyes), amblyopia (lazy eye), anisometropia (unequal refractive power), and media opacities (i.e.cataracts).

Correction of vision disorders at an early age may greatly improve a child's ability to see and hence learn.


By signing this form, you give permission for your child to participate in this screening event. You also agree that you understand and consent to the following. 

  • The information obtained from this vision screening is to be considered a preliminary procedure only and does not constitute a diagnosis of or absence of vision problems. It should be utilized only as a part of a comprehensive eye care program which includes periodic optometric/ophthalmological exams.
  • You as the parent or legal guardian understand that you rae responsible for arranging a full eye exam with an eye care professional if you are inform that such an exam is needed as indicated by the digital image eveluation.

  • All information collected by the Lions Club will be held in strictest confidence and stored in accordance with the New Mexico Medical Board medical records requirements and HIPAA (Health Insurance Portability and Accountability Act). Access to such information will only be available on a "need to know basis" by associates and/or employees of the New Mexico Lions Operation KidSight. Access by a private person or a medical care provider will only be made with and executed HIPAA medical release.

  • The Lions Club will not be held accountable for any errors of commission, omission, or other misdiagnosis.

Please screen my child. I have read and agree with the information on this sheet. I understnd that I will receive a follow-up report only if a vision problem is detected. I also understand that failure to sign this form will be considered as consent. 

Parent Signature: (initial here) 


We need to update our records with your child's past transcripts for a seamless educational record. Special Education transcript requests and evaluations will be treated as confidential and sent directly to Ann Marie Arguello

Mailing Address and Contact for Last School Attended:

School Name:   School City:   
State:  Zip:  
Phone:  Fax: 

Federal Law 99.31: "No parent signature required for educational records sent to another educational institution."

We will request education records on behalf of your child as needed from their last school attended.

Educational Records we may request: 

  • Official Transcript with interpretation of Grading Scale - Percentage
  • Comptency Exam/ Test Results
  • Complete Health Information
  • Withdrawl Grades
  • Birth Certificate
  • SBA Scores
  • Dicipline Status
  • IEP or 504 Plan (if applicable)

Special Education Records we may request:

  • Most Recent IEP
  • Eligibility Determination Statements
  • Evaluation Reports - Initial and Re-evaluation for:
    • Psycho-educational
    • Speech and Language
    • Physical Therapy
    • Psychological 
    • Occupational Therapy


Taos Academy Military Recruitment 'Opt Out' Form for release of name, address and telephone number

For Juniors and Seniors Only

There is no need to complete this section unless you are 'opting out'

Federal Public Law 107-110, section 9528 of the ESEA, "No Child Left Behind Act" requires school districts to release all 11th and 12th grade students' names, addresses, and phone numbers to military recruiters upon request. The law also requires the school district to notify students and parents of the right to opt-out from this by requesting that the district not release students' information to military recruiters. This form is intended to serve as a request to withhold this information.

As a student, you have a right to request that your private information is not released to military recruiters and others. Complete the following to withhold your information.

 I request that this student's name, address and telephone number NOT be released to Armed Forces and Military Recruiters, or Military Schools.

Parent/Guardian Signature:(Initial here) 


 I am 18 years old and request my own name, address, telephone number and school records NOT be released to the Armed Forces, Military, or Military Schools.

Student Signature:(Initial here)

Sign Complete Enrollment Packet

I/We the parent(s) of (student)  agree that all the information entered and selected above is true and correct to the best of our knowledge. I/We agree that I/we have read and reviewed the contents of this enrollment form with student and as a family, we understand the contents of this form and how our information will be used. 

Parent/Guardian Signature:(Initial here)   Date (00/00/0000) 

Second Parent/Guardian Signature: (Initial here)   Date (00/00/0000) 

Congratulations! You've completed your enrollment forms! We still need to have you return a number of State and Federally REQUIRED documents. You may do this in person, by delivering copies of these documents to the office, or emailing your electronic documents to Michelle Deherrera. Once you sign and submit this enrollment "packet" you will need to make sure that you bring/send us your additional documents.

You will need to submit:

  • Most Recent Report Card/Transcript
  • Current Immunization Record 
    • For those parents who choose to exempt their child from immunizations, a renewed and approved "CERTIFICATE OF EXEMPTION FROM SCHOOL/ DAYCARE IMMUNIZATIONS REQUIREMENTS" form will be requred to start school. Please remember to send in this form for renewal sometime during the end of July to have it available for start of school in August. You can go to https://nmhealth.org/publication/view/form/454/ for this form. Students without current immunizations or approved waivers will not be allowed to start school.
  • Birth Certificate (must be government Issued, hospital certificates are not acceptable)
  • ​​Proof of Insurance (copy of card)
  • Proof of Residence (phone bill, or lease/rent agreement in the name of the custodial parent)
  • Current 504 plan/Medical Diagnosis if applicable
  • Current IEP and Evaluation Report if applicable
  • Copy of Social Security Card for use at UNM if entering 10-12 grades
  • If student is a driver - submit copy of license and proof of auto insurance

​On submission, you will be redirected to a page where this list of required additonal documents can be found.

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