Oliver Pre K Application
Must be completed by legal guardian of student.
Email address *
Student Last Name *
Your answer
Student First Name *
Your answer
Student Middle Name *
Your answer
Date of Birth *
MM
/
DD
/
YYYY
Gender *
Physical Address *
Your answer
City *
Your answer
Zip Code *
Your answer
Student lives with *
First Guardian *
Your answer
Address *
Your answer
Email Address *
Your answer
Cell Phone *
Your answer
Employer *
Your answer
Highest Level Of Educational Attainment *
Your answer
Second Guardian
Your answer
Address
Your answer
Cell Phone
Your answer
Employer
Your answer
Highest Level of Educational Attainment
Your answer
Ethnicity and Race *
Student Connected to an Active Duty Military Family *
Student Connected to a Guard or Reserve Military Family *
PreSchool *
Required
Special Education Services *
Does this student have a previous Individualized Educational Plan? *
What language is spoken by you and your family most of the time at home? *
Your answer
Each child will be assessed. What is the best time? *
For more information contact Dr. Mesha Patrick at patricka@russellcsd.net
Your answer
A copy of your responses will be emailed to the address you provided.
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