PRE-KINDERGARTEN ENROLLMENT FORM
ENROLLMENT
DATE OF ENROLLMENT/Fecha de Inscripcion
MM
/
DD
/
YYYY
ETHNIC GROUP/Grupo Etnicidad
WHITE/Blanco
HISPANIC/Latino
BLACK/Negro
OTHER/Otro
ETHNICITY
MALE/FEMALE
STUDENT LAST NAME: Apellido
Your answer
STUDENT FIRST NAME/ Primer Nombre
Your answer
STUDENT MIDDLE NAME/Medio Nombre
Your answer
BIRTHDATE/Fecha de Nacimiento
MM
/
DD
/
YYYY
BIRTHPLACE/Lugar de Nacimiento
Your answer
CURRENT AGE/Edad Actual del Estudiante
Your answer
RESIDENCE ADDRESS/Direccion de Correo
Your answer
TELEPHONE NUMBER/ Numero de Teléfono
Your answer
MOTHER/GUARDIAN/Madre o Guaridan NAME/Nombre, ADDRESS/Direccion de Correo, PHONE NUMBER/Numero de Teléfono & EMAIL ADDRESS/Direccion Electronico
Your answer
FATHER/GUARDIAN/Padre o guardian Legal NAME/Nombre, ADDRESS/Direccion de Correo, PHONE NUMBER/Numero de Teléfono & EMAIL ADDRESS/Direccion Electronico
Your answer
SCHOOL LAST ATTENDED WITH ADDRESS AND PHONE NUMBER/Ultima Escuela que Asistio y Direccion de la escuela
Your answer
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