2018-2019 Kindergarten (5K) Student Data
Please enter information for Kindergarten (5K) students beginning in the fall of 2018.

At this time, we are only in the collection process. We will contact you as soon as we have more information to share, such as upcoming meeting dates. Feel free to contact us at any time if you have any questions prior to upcoming meetings.

Email contact is Mrs. Nadine Westphal: nwestphal@rvschools.org

Email address *
Student Legal LAST Name *
Your answer
Student Legal FIRST Name *
Your answer
Student Legal MIDDLE Name *
Your answer
Gender *
Date of Birth *
MM
/
DD
/
YYYY
Physical Street/Road Address (If Mailing Address is different, enter below) *
Your answer
City *
Your answer
State *
Your answer
Zip Code *
Your answer
Mailing Address (If different than physical address. Please include address, city, and zip code).
Your answer
Biological Mother's Full Name *
Your answer
Does biological mother live at same address as student? *
Mother's Address** (**ONLY if different than student's)
Mother's Telephone Number *
Your answer
Mother's E-Mail Address *
Your answer
Biological Father's Full Name *
Your answer
Does biological father live at same address as student? *
Father's Address** (**ONLY if different than student's)
Your answer
Father's Telephone Number
Your answer
Father's E-Mail Number
Your answer
Did Student attend a pre-school or 4K? *
If student attended a pre-school or 4K, where did student attend? *
Questions or Comments - Please type below.
Your answer
A copy of your responses will be emailed to the address you provided.
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