Screening Sign-Up
Please complete and submit this form to sign your child up for a preschool screening.

The email address you submit will be used to send all paperwork and screening materials. PLEASE be sure that you use an email address that you can check regularly.
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Email *
Child's Name (FULL NAME) *
Child's Date of Birth *
MM
/
DD
/
YYYY
Parent's Name (FIRST AND LAST) *
Phone Number *
Session Preference (Check ALL that will work, as there are very limited full day openings) *
Required
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This form was created inside of Taylorville Community Unit School District #3.

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