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Estill County Kindergarten Enrollment Form
Please fill out this form in order to register your upcoming Kindergartner for school. We will collect the proper documents at a later date this summer. Thanks!
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* Indicates required question
Student's Last Name
*
Your answer
Student's First Name
*
Your answer
Student's Middle Name
*
Your answer
Gender
*
Male
Female
Prefer not to specify
Birth Date
*
MM
/
DD
/
YYYY
State of Birth
*
Your answer
County of Birth
*
Your answer
Reachable Phone Number
*
Your answer
2nd Phone Number
Your answer
Ethnicity
*
White (Not of Hispanic Origin)
American Indian or Alaskan Native
African American (Non Hispanic Origin)
Asian or Pacific Islander
Hispanic
Other
Street Address
*
Your answer
City
*
Your answer
State
*
KY
Other:
Zip Code
*
Your answer
Transportation: How will my student get to school and back home?
*
Ride Bus twice a day (morning and afternoon)
Bus morning ONLY
Bus afternoon ONLY
Parent Pick Up ONLY
Parent/Guardian Information: Last Name
*
Your answer
Parent/Guardian Information: First Name
*
Your answer
Parent/Guardian Information: Relationship to student
*
Mother
Father
Grandparent/Family Member
Legal Guardian
Foster Parents
Guardian 2 Last Name (If applicable)
Your answer
Guardian 2 First Name (If applicable)
Your answer
Guardian 2 Relationship to student
Mother
Father
Grandparent/Family Member
Legal Guardian
Foster Parents
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Other Children Under 18 Living in the Home (Name, Age, School Attending, Relationship to Student)
Your answer
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