Kindergarten Registration
Welcome to Minerva Elementary! We are so excited that your child is going to be a Class of 2033 Minerva Lion. This is the first step in the kindergarten registration process. You will be receiving an email upon submission of this form that will explain the next step in this process. If you do not receive an email within 24 hours, please check your spam folder. Complete by May 29.
Email address *
Student First Name - must match birth certificate *
Your answer
Student Middle Name - must match birth certificate *
Your answer
Student Last Name - must match birth certificate *
Your answer
Nickname - if student does not go by first name
Your answer
Student Social Security Number *
including dashes
Your answer
Gender *
Birth Date *
MM
/
DD
/
YYYY
City & State of Birth *
Your answer
Child's Ethnicity *
Child's Home Address - House Number & Street *
Your answer
Child's City *
Your answer
Child's Zip *
Your answer
Child's County of Residence *
Is Student Applying for Open Enrollment *
Mother's Maiden Name *
Your answer
Primary Contact First & Last Name *
Your answer
Primary Contact Relationship *
Primary Contact Telephone *
including dashes
Your answer
Primary Contact Email Address *
Your answer
Does a court order exist concerning custody of child? *
Next
Never submit passwords through Google Forms.
This form was created inside of Minerva Local School District. Report Abuse