21-22 KG Round Up Online Registration
Student Information
Student First Name (as it appears on student's birth certificate) *
Student Middle Name *
Student Last Name *
Birthdate *
MM
/
DD
/
YYYY
Gender *
Do you live in Eastbrook District? *
Is your student currently enrolled in a Pre-School? *
For what school are you registering? *
Ethnicity (Hispanic/Latino)? *
Federal Race *
What is your home language? *
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