JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Kindergarten Registration
Enrollment is still open!!!! If you missed round up but have a child that will be joining us in the fall, register now! Please complete one form per child.
There will be additional "official" paperwork that will need to be completed for the school.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
Child's Legal LAST NAME
(complete this form for each individual child)
*
Your answer
Child's Legal First Name
(complete this form for each individual child)
*
Your answer
Child's Legal Middle Name
(complete this form for each individual child)
*
Your answer
Child's Date of Birth
*
MM
/
DD
/
YYYY
Child's Gender
*
Male
Female
Other:
Parent/Guardian's LAST NAME
*
Your answer
Parent/Guardian's FIRST NAME
*
Your answer
Parent/Guardian's Phone Number
*
Your answer
Second Parent/Guardian's LAST NAME (optional)
Your answer
Second Parent/Guardian's FIRST NAME (optional)
Your answer
Second Parent/Guardian's Phone Number
Your answer
Guardian's Physical address
*
Your answer
Guardian's Mailing address (if different from physical address)
Your answer
Send me a copy of my responses.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
Privacy
Terms
This form was created inside of Eureka Public Schools Dist #13.
Does this form look suspicious?
Report
Forms
Help and feedback
Contact form owner
Help Forms improve
Report