Preschool for All (PFA) Screening
Please provide the below information in order to be added to our mailing list and to be notified of future screening dates. All children must be screened to be considered for entrance into the PFA program; placement is not guaranteed.      


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Email *
Child's First Name *
Child's Middle Name
Child's Last Name *
Date of Birth *
MM
/
DD
/
YYYY
Child's Gender *
Do you have concerns about your child's development? *
If yes, what concerns do you have?
Parent/Guardian *
Parent/Guardian
Address *
City *
State *
Zip Code
Phone Number *
Alternative Phone Number
Native Language *
Required
Language at home *
Required
Ethnicity *
How did you hear about the preschool program? *
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