Kindergarten Enrollment
This enrollment form is a shortened version to help the District identify students who are Kindergarten age. Students entering Kindergarten must be 5 years old by August 1st. All students must reside in the Hermitage School District. Full registration and screening dates will be announced at a later time. Please email Mrs. Kobe at skobe@hermitage.k12.mo.us if you have any questions or call the elementary office at 417-745-6277.
Child's Name *
Your answer
Date of Birth (Month, Day, Year) *
Your answer
Address *
Your answer
City, State, Zip *
Your answer
Sex *
Mother or Legal Guardian (Last, First, Middle) *
Your answer
Phone Number (Home/Cell) *
Your answer
Father or Legal Guardian (Last, First, Middle) *
Your answer
Phone Number (Home/Cell) *
Your answer
Parent Electronic Signature: I completed this form and I certify that the information above is accurate. I understand that providing false information for purposes of defrauding the government is punishable by law. (Please type full name below.) *
Your answer
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