District 62 Mini STAR/Baby Talk Book Times Program (Families with children Ages Birth to 3 )

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

This program is available to families living in School District 62 Des Plaines. If you are interested and would like more information about this program please contact Julie Ritzema/ 847-789-5613.

Email *

Date:

YYYY

Child's Name:

Birthdate:

YYYY

Gender:

Male

Female

Clear selection

Parent/Guardian:

Relationship:

Address:

Home Phone:

Cell Phone:

A copy of your responses will be emailed to the address you provided.

Submit

Clear form

Never submit passwords through Google Forms.

reCAPTCHA

Privacy Terms

This form was created inside of Community Consolidated School District 62. Report Abuse

Forms