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LCPS Kindergarten Registration
Kindergarten Registration form - required information is designated with an asterisk
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* Indicates required question
Email
*
Your email
SCHOOL NAME
*
Dryden
Elk Knob
Flatwoods
Rose Hill
St. Charles
Required
STUDENT FIRST NAME
*
Your answer
STUDENT MIDDLE NAME
Your answer
STUDENT LAST NAME
*
Your answer
STUDENT HOME ADDRESS
*
Your answer
STUDENT MAILING ADDRESS (if different than Home Address)
Your answer
Home Phone Number
*
Your answer
Date of Birth
*
MM
/
DD
/
YYYY
Birth Certificate Number
Your answer
Birth City/State
*
Your answer
Gender
*
Male
Female
Non-Binary
Allergies
Your answer
Doctor Name & Phone Number
Your answer
Race (Check all that Apply)
*
American Indian/Alaska Native
Asian
Black or African American
Native Hawaiian/Other Pacific Islander
White
Required
Is the student Hispanic or Latino?
*
Yes
No
Required
Birth Country
*
Your answer
Home Language
*
Your answer
Immigrant
*
Yes
No
What is the primary language used in the home, regardless of the language spoken by the student?
*
Your answer
What is the language most often spoken by the student?
*
Your answer
What is the language that the student first acquired?
*
Your answer
Is the student one of the following?
*
Choose
Unsheltered (car, campground, abandoned buildings)
Doubled-Up (multiple families living within the same household) - due to economic hardship
Living in a shelter
Living in a hotel/motel - due to lack of a fixed, regular, and adequate nighttime residence.
None of These
Is the student militarily connected?
(one of more parents/guardians are in the military)
*
Yes
No
Is the student in foster care?
*
Yes
No
Did the student attend headstart?
*
Yes
No
Will the student be riding a bus?
*
Yes
No
Maybe
Please select one of the following concerning internet access at home residence:
*
Choose
Internet access allows for live streaming, classroom instruction, real time interaction
Internet access too slow for streaming or real time interaction
No internet due to cost
No internet due to availability
No internet due to unknown reasons
Will the student be participating in remote learning?
*
Yes
No
Last School Attended
(if any):
Your answer
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