Lake Elsinore Unified School District Operation School Bell Application 1 Date & Time2 Participation Eligibility3 Income Verification4 Student Information5 Family Information Shopping event location: Target, 18287 Collier Avenue, Lake Elsinore* August 17th, Tuesday (0 spots) August 31st, Tuesday (0 spots) September 7th, Tuesday (0 spots) September 21st, Tuesday (0 spots) Your student must be present for the Shopping Event and may be registered only one time.Arrival Time:* 4:00pm 5:00pm Your student must be present for the Shopping Event and may be registered only one time. Participation Eligibility Before you proceed, you will need to confirm that, based on the income chart below, your Total Family Yearly Income from all sources qualifies you to participate in the shopping event. Participation Eligibility Confirmation*By checking the spaces below you are confirming that: Based on my Total Family Yearly Income my student(s) are eligible to participate. I understand that website registration is the ONLY way my student(s) can register for a shopping event. No phone or email registrations will be accepted.Register only once per student. Income Verification Total Family Yearly Income Confirmation* Yes, I understand Student Information The following information is required for each student (Transitional K-12) Registered for a shopping event.Student Last Name*Enter the Student's informationStudent First Name*Enter the Student's informationGender*Make a selectionMaleFemaleOtherEnter the Student's informationDate of Birth* MM DD YYYY Enter the Student's informationAge*Please enter a number from 4 to 18.Enter the Student's informationGrade*Make a SelectionT-KindergartenKindergarten1st Grade2nd Grade3rd Grade4th Grade5th Grade6th Grade7th Grade8th Grade9th Grade10th Grade11th Grade12th GradeSelect Elementary School*Make a SelectionAlberhillCottonwood CanyonDonald GrahamEarl WarrenElsinoreLakeland Village SchoolLuiseno SchoolMachadoRailroad CanyonRice CanyonRonald ReaganTuscany HillsWildomarWilliam CollierWithrowLake Elsinore Unified School DistrictSelect Middle School*Make a SelectionCanyon LakeDavid A. BrownElsinore MiddleTerra CottaLake Elsinore Unified School DistrictSelect High School*Make a SelectionElsinore HighLakeside HighOrtega HighTemescal Canyon HighLake Elsinore Unified School DistrictStudent Street Address* Street Address City ZIP Code Enter the Student's informationEthnicity: (Select ONLY one from the Single-race or Multi-race categories) Single race category White Black/African American Asian American Indian/Alaskan Native Native Hawaiian/Other Pacific Islander Enter the Student's informationMulti-race Category American Indian/Alaskan Native & White Black/African American & White Hispanic/Black/African American Hispanic/American Indian/Alaskan Native Hispanic/Native Hawaiian/Other Pacific Islander Hispanic/American Indian/Alaskan Native & White American Indian/Alaskan Native & Black/African American Hispanic/American Indian/Alaskan Native & Black/African American Other Multi-race (ONLY if, non-of-the-above categories identifies you) Asian & White Hispanic/White Hispanic/Asian Hispanic/Asian & White Hispanic/Black/African American & White Enter the Student's information Family InformationParent/Guardian Last Name*Parent/Guardian First Name*Relationship to Student*Make a SelectionGuardianGrandfatherGrandmotherUncleAuntFatherMotherSisterBrotherCousinTotal Family Size*Female Head of Household* Yes No Parent/Guardian Email Address* Enter Email Confirm Email Phone Number*Do you have another student to register?* Yes No Unique ID
