Five Year Old Kindergarten Registration
Please complete this form ONLY if you have NOT completed a hard copy form and sent it to your neighborhood elementary school.
Email address *
Student Name *
Last, First, Middle
My child's neighborhood school is: *
Birthdate *
MM
/
DD
/
YYYY
Gender *
Birthplace *
City, State, County
Ethnicity/Race *
Part 1
Ethnicity/Race *
Part 2
Primary Home Language *
Part 2
E-mail
Parent/Guardian of child at SAME ADDRESS as student listed above: *
Home Phone of Parent/Guardian 1 *
Cell Phone of Parent/Guardian 1
Work Phone of Parent/Guardian 1
Address *
Street Address, City/State/Zip Code
Other Children living at the SAME address as the student listed
Child's Names (Last, First, Middle), Date of Birth, Male/Female, Grade, School Attending
A copy of your responses will be emailed to the address you provided.
Submit
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