Clayton School District's Parents as Teachers
*Each school district has their own Parents As Teachers program. If you live outside of the Clayton school district, google "Parents as Teachers"+ the school district you live in to find contact information. 

Clayton Schools' Family Center
301 N. Gay Ave., 63105
314-854-6900
www.parentsasteachers.org

Sign in to Google to save your progress. Learn more
Your Full Name *
Today's Date:  *
MM
/
DD
/
YYYY
Your address including zip code *
Email and cell: *
Parent no. 2- full name: *
Parent no. 2's mailing address IF different than above: 
Parent No. 2, cell and email: *
What is the primary language spoken in your home? *
If English is not your first language, will you need an interpreter on visits with your parent educator?
CHILDREN UNDER 6 (not yet in kindergarten)
1. Full Name (Including middle name)**
2. Date of Birth
3. Gender

 *
Do you have concerns about any of these children? *
CHILDREN OVER 5                                            
1. Name    2.  Age    3.  School they attend                   
4. Classroom Teacher's name  
 *
Have you ever participated in Parents as Teachers before?  If so, in what school district? *
How did you hear about Parents as Teachers? *
Submit
Clear form
Never submit passwords through Google Forms.
GoogleForms
This form was created inside of School District of Clayton.