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Dual Immersion Interest Form 2018 - 2019 (English)
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* Indicates required question
Email
*
Your email
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?
*
Kindergarten
First
Second
Third
Fourth
Language Spoken at Home
*
Choose
Spanish
English
Both English and Spanish
Has Student attended Pre-school or TK?
*
Yes
No
Are siblings currently enrolled in the Dual Immersion Program?
*
Yes
No
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?
Yes
No
Clear selection
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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