Kindergarten Jumpstart & Screening Visit
Set up your KSD Jumpstart & Screening Visit by filling out this form. After filling out this form, you will be contacted by a staff member to set a specific date and time for your appointment.

To find out more about Jumpstart and Round Up, visit our website. https://www.ksdr1.net/news/ksdjs20/
Parent/Guardian's First Name *
Your answer
Parent/Guardian's Last Name *
Your answer
Parent/Guardian's Preferred Number *
Your answer
Preferred Email Address *
Your answer
Child's Legal First Name *
Your answer
Child's Legal Last Name *
Your answer
Child's Date of Birth *
MM
/
DD
/
YYYY
Preferred Appointment Time *
After filling out this form, you will be contacted by a staff member to set a specific date and time for your appointment.
Home Address *
Please include house number, street address, city, state and zip code
Your answer
Elementary School your Child Will Attend 20-21 *
Are you in the PAT Program *
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