Kindergarten Pre-Enrollment Form
STUDENT INFORMATION
Legal name as it appears on the birth certificate
LAST NAME *
Your answer
FIRST NAME *
Your answer
MIDDLE NAME
Your answer
GENDER *
DATE OF BIRTH (mm/dd/yyyy) *
MM
/
DD
/
YYYY
GRADE *
Your answer
STUDENT CONTACT PHONE: (XXX-XXX-XXXX) *
Your answer
BIRTH PLACE (CITY - STATE - COUNTRY)
Your answer
PRIMARY HOUSEHOLD INFORMATION:
(Address where student resides. This is the physical location of the household. Do not enter a PO box. Student information, mailings and parental portal access will be provided to custodial adults at this address.)
ADDRESS: *
Your answer
CITY, STATE, ZIP *
Your answer
STUDENT LIVES WITH: *
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