Virtual Summer Preschool Program Registration
Held virtually on Tuesdays and Thursdays
Email address *
Your answer
Student's First Name *
Your answer
Student's Last Name *
Your answer
Date of Birth (child must be 2 1/2 years old by Sept 1, 2020, fully potty-trained and able to self-care) *
MM
/
DD
/
YYYY
Gender *
Social Security Number
Your answer
Student's Street Address *
Your answer
Student's Zip Code *
Your answer
Parent's First Name *
Your answer
Parent's Last Name *
Your answer
Parent's Street Address *
If different than student's
Your answer
Parent's Zip Code *
If different than student's
Your answer
Parent's Home Phone *
Your answer
Parent's Cell Phone *
Your answer
Current School
Your answer
Special Needs
Your answer
How did you find out about our program? *
Completed by *
Type your full name
Your answer
Your relationship to the student *
Your answer
Date form completed. *
MM
/
DD
/
YYYY
Submit
Never submit passwords through Google Forms.
This form was created inside of Shepherd of the Woods Lutheran School. Report Abuse