2017-2018 Preschool Registration Request
Please complete every section of this form. Incomplete forms cannot be processed.
Select 1st and 2nd choice for Preschool Class from the drop down menu.
3 year-olds must have their third birthday by September 1, 2017 .
4 year-olds must have their fourth birthday by December 2, 2017.
Email address
Parent First Name
Your answer
Parent Last Name
Your answer
Home Address (Number and Street)
Your answer
Your answer
Zip Code
Your answer
Phone number
Your answer
Child's Name
Your answer
Child's Birth Date (mm/dd/yyyy)
Your answer
Was a sibling of this student in one of PUSD preschool classes
Full Day or Part Day
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