Preschool Learning Partner Screening Form
Please complete the following information for the office staff at East Haddam Elementary School.

Appointments for a development screening and interview will be scheduled in the spring. All children need to follow this process before being considered for the preschool learning partner program. Eligible children will be chosen by the lottery method. Further information regarding your child's screening date and time will be mailed to you after your information is received.

If you have any questions please call Denise Russo (860) 873-5076 or email her at
Email address *
Child's First Name *
Child's Last Name *
Child's Date of Birth *
Clear selection
Mailing Address *
City *
State *
Zip Code *
Guardian's First Name *
Guardian's Last Name *
Guardian's Phone Number *
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