PreKindergarten Enrollment Form
Maple Run Unified School District - Serving the residents of Fairfield, St Albans City and St Albans Town
Email address *
Student Last Name *
Your answer
Student First Name *
Your answer
Student Middle Name
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Student Date of Birth *
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DD
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Student Gender *
Is the Student Hispanic or Latino? *
Child's Race (select all that apply) *
Required
Has your child received any of these services?
Please describe any concerns you have about your child?
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Parent 1 Name *
Your answer
Parent 1 Street Address *
Your answer
Parent 1 City *
Your answer
Parent 1 Phone Number *
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Address where Legal Parent 1 pays rent or taxes *
Your answer
Parent 2 Name
Your answer
Parent 2 Street Address
Your answer
Parent 2 City
Your answer
Parent 2 Phone Number
Your answer
Address where Legal Parent 2 pays rent or taxes
Your answer
Where would you prefer that your child attend preschool? *
Required
A copy of your responses will be emailed to the address you provided.
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