2017-18 Preschool Registration / West Jordan
Please complete the information below to register for the preschool at West Jordan High School for the 2017-18 school year. Thank you!
Student - First Name, as it appears on birth certificate
Your answer
Student - Middle Name, as it appears on birth certificate
Your answer
Student - Last Name, as it appears on birth certificate
Your answer
Student - Nickname, if applicable
Your answer
Student - Date of Birth
MM
/
DD
/
YYYY
Student - Gender
Student - Race
Your answer
Student - Language
Your answer
Address
Your answer
City
Your answer
Zip Code
Your answer
Parent/Guardian #1 - First Name
Your answer
Parent/Guardian #1 - Last Name
Your answer
Parent/Guardian #1 - Relationship to Student
Your answer
Parent/Guardian #1 - Phone Number
Your answer
Parent/Guardian #1 - Phone Number Type
Parent/Guardian #1 - Email address
Your answer
Parent/Guardian #2 - First Name
Your answer
Parent/Guardian #2 - Last Name
Your answer
Parent/Guardian #2 - Relationship to Student
Your answer
Parent/Guardian #2 - Phone Number
Your answer
Parent/Guardian #2 - Phone Number Type
Parent/Guardian #2 - Email address
Your answer
Emergency Contact, other than Parent/Guardian listed above. Include name, relationship, and contact number.
Your answer
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