Online Margaret Mace School Preschool Registration
Before starting in our Preschool Program, families will need to provide proof of residency, immunization records and original birth certificate (not a copy).
Email Address: *
Student's Legal Name (Last Name, First Name, Middle Name) *
Parent/Guardian Name(s) (Last Name, First Name) *
Home Address (Street, City, Zip Code) *You will be required to provide proof of residency.* *
Cell Phone (Area Code and Number) *
Home Phone (Area Code and Number) *
Child's Date of Birth (Month/Day/Year) *
MM
/
DD
/
YYYY
City, State and County of Birth *
Gender *
Ethnicity (Check all that apply. Completion of this section is optional and is used for compliance with Federal and State reporting requirements.)
Child's Native Language *
Language spoken at home *
Child is living with (Check One)
Clear selection
Pediatrician *
Please indicate any medical concerns for your child, including allergies. *
Please list any medications your child takes. *
Is your child toilet trained?
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List any other helpful information. *
Social-Emotional/Behavioral Skills (Check all that apply)
Yes
No
Sometimes
Hits others
Talks back
Verbally fights with others
Constantly seeks attention
Difficulty separating from parents
Takes turns/shares with others
Makes new friends easily
Adjusts to changes
Clear selection
Check all that apply
If you checked any of the statements above please explain (all information obtained is confidential).
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