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Acacia Network Pre-K Interest Form
Please fill out this form if you are interested in potentially enrolling your child in Acacia Network's Head Start, Pre-K, or 3-K programs. 
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First Name / Nombre *
Last Name / Apellido *
Email *
Address / Dirección *
Phone number / Teléfono *
Child's birth date / Fecha de nacimiento de su hijo(a) *
MM
/
DD
/
YYYY
Please select the daycare of your choice. 
Favor de escoger el centro de su preferencia. 
*
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