Kindergarten 2019-20
Please fill out all information. Please use Full Name on Birth Certificate
Student First Name *
Your answer
Student Last Name *
Your answer
Birthday *
MM/DD/YYYY
Your answer
Gender *
M or F
Home Phone
If you only have a cell list it here
Your answer
Street Address *
Your answer
City *
Your answer
State *
Your answer
Zip *
Your answer
Mailing Address
If different than above
Your answer
Mailing City
If different than above
Your answer
Mailing Zip
Your answer
Mother's Name
Full name(Jane Doe)
Your answer
Father's Name
Full Name(John Doe)
Your answer
Mother Day time Phone
Your answer
Father Day time Phone
Your answer
Mother Cell Phone
Your answer
Father Cell Phone
Your answer
Ethnicity *
Email address
Your answer
Will your student be riding the bus? *
Required
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