Child Find Pre-K Screening Registration:
Please provide the following information about your child. Thank you!
Email address *
My child's full legal name (first, middle, & last) is: *
Your answer
My child's date of birth is: *
MM
/
DD
/
YYYY
My child is a: *
My child's race is: *
Required
My child's ethnicity is: *
What language/s are spoken in the home? *
Required
Has your child ever received any of the following services? *
Past - More than 1 year ago
Past Less than 1 year ago
Currently receives
Never / Not applicable
Speech/Language Therapy
Occupational Therapy
Physical Therapy
Behavior (ABA) Therapy
Counseling
Early Steps (birth to 3rd birthday)
My child currently attends ___________________. *
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