Burrillville Registration Forms

Parents or Guardians who reside in Burrillville and wish to register students in the public schools of Burrillville MUST complete the New Student Registration From AND the Residency Affidavit, which can be downloaded at the bottom of the page.

Registration for new students occurs at each individual school.  Please see the school's website for the addresses, phone numbers, hours, and driving directions to our schools.

NOTE: these forms are only part of the registration paperwork - parents or guardians will still be required to visit the attending school to pickup a complete registration packet.

Proof of Residency
Proof of residency is required.  The person with whom the student lives must attach proof of residency, dated within the last thirty (30) days and must show parent, guardian or legal name and street address.

Please carefully read the scenarios listed below and provide the documentation that applies to the student’s living situation.

Possible Living Situation #1
If you own and live in the resident property, please attach both:
  • A Town of Burrillville Tax Bill or a Mortgage Statement in your name showing residence property address AND
  • TWO (2) utility bills in your name for the current month showing the residence property address. For example:
    • Electric bill
    • Cable bill
    • Telephone or cell phone bill
    • Gas or oil bill
Possible Living Situation #2
If you rent and live in the resident property, please attach:
  • Copy of the lease/rental agreement AND
  • TWO (2) utility bills in your name showing residence property address OR, if such service is included as part of the rental agreement, you must provide satisfactory evidence that is so included AND ONE (1) of the items listed below:
    • Mortgage Statement OR Town of Burrillville Tax Bill of the property owner.
    • Current vehicle tax bill
    • One other bill mailed to you at your residence address
Possible Living Situation #3
If you are living at a property with the owner or renter of the property in Burrillville, please attach:
  • The Residence Affidavit signed by the primary resident of the home (owner or renter) and subscribed and sworn before a Notary Public AND
  • A utility bill in the name of the primary resident of the home showing residence property address or, if such service is included as part of the rental agreement, you must provide satisfactory evidence that is so included AND ONE (1) of the items listed below:
    • Current vehicle registration showing residency property address; OR
    • One other bill mailed to you at your residence address
NOTE: If legal custody of a child is split between two parents, in ADDITION to the documents listed above, you must also attach a certified copy of the most recent court order identifying each parent’s respective award of physical custody. You are responsible to immediately inform the school of any changes to the court order.

Other Requirements
  • Valid birth certificate
  • Proof of Immunizations
All requested information must be provided before a student may start classes




Burrillville Kindergarten Registration Information

For information on this year's Kindergarten Registration Open House, see this poster!

For Burrillville children entering Kindergarten in September 2017

* Child must turn 5 by September 1st, 2017 *

Parents or guardians who reside in Burrillville and wish to register students in Kindergarten must provide all of the required forms listed in the first section of this page.

Parent Notification of Kindergarten Health Requirements:

Dear Parent/ Guardian,

State law requires that any child entering kindergarten must have documented evidence of the following:

1. Immunizations:
  • DTP (Diphtheria, Tetanus, Pertussis) 5 doses
  • IPV/ OPV (polio) 4 doses
  • Hepatitis B 3 doses
  • MMR (measles, mumps rubella) 2 doses
  • Varicella 2 doses or proof of chicken pox disease.
2. Physical examination:
  • must be dated within 1 year of the start of school.
  • Proof of vision screening by a licensed provider.
  • Proof that lead screening was done.
Please note that any information missing from your child’s health record will result in registration delay for your child. Your child will not be allowed to enter school until all necessary information is received.

If you have an appointment scheduled to meet compliance with the above requirements, notify me of the physician name and scheduled date so that I may contact them for verification. Please contact me for any questions, concerns, or difficulties you may be have obtaining the required information prior to the end of school in June. All information submitted over the summer will be reviewed prior to the start of school.

Thank you for your cooperation,

Linda Allard, R.N., RICSNT
401-568-1340

Children may be screened by Child Outreach at registration, or by calling Child Outreach at 401-647-7560 to make an appointment.

For more information on Kindergarten Registration, please contact the Austin T. Levy School at 401-568-1340.

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Justin Allen,
Oct 6, 2015, 9:57 PM
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Justin Allen,
Jan 23, 2017, 8:42 AM
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Justin Allen,
Jan 20, 2017, 9:10 AM