Dual Immersion Interest Form 2018 - 2019 (English)
Email address *
Student's First Name *
Your answer
Student's Middle Name *
Your answer
Student's Last Name *
Your answer
Student's Date of Birth *
MM
/
DD
/
YYYY
What Grade will the student be in for the 2018-2019 school year? *
Language Spoken at Home *
Has Student attended Pre-school or TK? *
Are siblings currently enrolled in the Dual Immersion Program? *
Name of siblings currently enrolled in the Dual Immersion Program
Your answer
Parent/Guardian's Last Name *
Your answer
Parent Guardian's First Name *
Your answer
Home Address *
Your answer
City *
Your answer
Zip Code *
Your answer
Telephone/Cell Phone Contact *
Your answer
Does the student live within San Jacinto Unified School District Boundaries?
What is the student's school of residence?
Your answer
A copy of your responses will be emailed to the address you provided.
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