SPLASH! Spanish Language Immersion Program 2022-2023 Kindergarten Application
Bethany Elementary, South End Elementary, and Stoneville Elementary Schools are accepting applications for kindergarten students for their Spanish Language Immersion Programs. Students will be placed in the program in the order in which the applications are received until the class is full. If a student is not selected, he/she will be placed on the waiting list. If applying for more than one child, please complete a separate application for each child.  
Student Name *
Gender *
Race *
Date of Birth *
Parent / Guardian Name(s) *
Address (Street, City, State, Zip Code) *
Home Phone *
Cell Phone *
Work Phone
Email Address *
What is the primary language spoken at home? *
Attendance Zone School Assignment:
1st Choice *
2nd Choice *
3rd Choice *
Are you an employee of Rockingham County Schools? *
Does the applicant have a sibling in the SPASH! Program? *
How did you hear about the immersion program?
Name of Individual Completing This Form *
*If you have any questions, please contact Nancy Towler*
Phone: 336-627-2600
Email: ntowler@rock.k12.nc.us
A copy of your responses will be emailed to the address you provided.
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