*Black Rock Elementary Kindergarten Registration Program Preference
The application deadline for 2017/2018 Kindergarten was January 17, 2017. We are still accepting applications, however due to the large amount of Full Day applications, we may have to put your child on a wait list. Please call the office after you have submitted this form. A $145 registration fee will be required AFTER notification of acceptance. If you have any questions, please contact Kathy Embler at 720-890-3995 or embler_kathleen@svvsd.org.
Student First Name
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Student Last Name
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Student Date of Birth (DOB)
MM
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DD
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YYYY
Student Gender
Parent First Name, Last Name (Best Contact)
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Parent Phone Number (Best Contact)
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Parent Email Address (Best Contact)
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Household Address
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Program Preference # 1
Program Preference # 2
Comments
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