2018-2019 Pacific Preschool Interest Form
Please complete a separate form for each child.
NOTE: Age-appropriate preschool students enrolled by January 1 receive PRIORITY ENROLLMENT in kindergarten for the following school year.
Email address *
Student's last name *
Your answer
Student's first name and middle initial *
Your answer
Student's date of birth *
MM
/
DD
/
YYYY
Student's physical street address *
Your answer
Desired program (check one) *
Required
Parent 1 first and last name *
Your answer
Parent 1 phone number(s) *
Your answer
Parent 1 best email address *
Your answer
Parent 2 first and last name
Your answer
Parent 2 phone number(s)
Your answer
Parent 2 best email address
Your answer
For information purposes only and for the sole purpose of determining capacity and space issues which would require the creation of a new program or service, has your student or does your student currently receive special education or other special services? *
Does your student have a sibling who is currently enrolled in Pacific School and will be enrolled in 2018-19? *
Is either parent active-duty military personnel?
A copy of your responses will be emailed to the address you provided.
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