BES Registration Form
STUDENT INFORMATION
Student's Last Name *
Student's First Name *
Student's Full Middle Name *
Student's Street Address *
Student's Primary Phone *
Male/Female *
Date of Birth *
MM
/
DD
/
YYYY
Ethnicity (Hispanic or Latino) *
Race(s) choose 1 or more *
Required
Student resides with *
Required
Information for Other* (Foster Parent, grandparent, guardian)
Did your child attend Preschool in the year before Kindergarten? *
Where (if not applicable enter N/A) *
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