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Kindergarten Screening Scheduler
Complete this form to begin the new kindergarten registration for the 2024-2025 school year.
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* Indicates required question
Email
*
Your email
Screening Date:
*
Please choose "1" date below.
Choose
Tuesday, May 28th
Wednesday, May 29th
Screening Time:
If you choose
Tuesday, May 28th
, please pick '1' time below.
Choose
8:15 -9:45
10:00 - 11:30
1:00 - 2:30
Screening Time:
If you choose
Wednesday, May 29th
, please pick '1' time below.
Choose
8:15 -9:45
10:00 - 11:30
1:00 - 2:30
Child's Legal Name from Birth Certificate:
First Name:
*
(From Birth Certificate)
Your answer
Middle Name:
(From Birth Certificate)
Your answer
Last Name:
*
(From Birth Certificate)
Your answer
Birth Date: (MM/DD/YYYY)
*
Child's date of birth
Your answer
Gender:
*
Choose
Female
Male
Home Address: (# Street Apt. #, City, State, Zip)
*
Your answer
Parent Name: (Last)
*
Primary parent for enrollment purposes.
Your answer
Parent Name: (First)
*
Primary parent for enrollment purposes.
Your answer
Phone Number:
*
(XXX) - XXX - XXXX
Your answer
Parent Email Address:
*
(Double check for errors)
Your answer
Custody
*
Is there a custody or parenting agreement in place for the child?
Yes
No
Other siblings in the district:
(If this item doesn't pertain to you mark with NA)
Your answer
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