2020-2021 Kindergarten Preregistration
Please help us get started with the registration process for next year's kindergarten students by completing the form below. We will have other items for you to fill out and hopefully a screening process as the state guidelines will allow. Thank you for your time. Please continue to follow our Facebook page and check your email for updates.
Child's Name (First, Middle, Last)
Date of Birth (MM/DD/YYYY) Child must be 5 years old on or before September 1, 2020
Prefer not to say
Native Hawaiian/Pacific Islander
American Indian/Alaskan Native
More than one race
Prefer not to answer
Home Street Address
Mailing Address (if P.O. Box)
Child lives with
Guardian DCFS placement
Guardian Other relation to student
1. Parent/Guardian Name - First Contact (First Name, Last Name)
1. Parent/Guardian Address (street, city)
1. Parent/Guardian email address
1. Parent/Guardian phone number ###-###-####
2. Parent/Guardian Name - Second Contact (First Name, Last Name)
2. Parent/Guardian Address (street, city, zip)
2. Parent/Guardian email address
2. Parent Guardian phone number ###-###-####
Never submit passwords through Google Forms.
This form was created inside of Cumberland CUSD #77.