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Preschool Screening Scheduler
Complete this to begin the new preschool registration for the 2024-2025 school year
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* Indicates required question
Email
*
Your email
Screening Date:
*
Please choose "1" date below.
Monday, March 18th
Tuesday, March 19th
Screening Time: (Monday, March 18th)
If you choose
Monday, March 18th
, please pick '1' time below.
Choose
8:00-8:30
8:30 - 9:00
9:00 - 9:30
9:30 - 10:00
10:00 - 10:30
10:30 - 11:00
11:00 - 11:30
11:30 - 12:00
1:00 - 1:30
1:30 - 2:00
2:00 - 2:30
Screening Time: (Tuesday, March 19th)
If you choose
Tuesday, March 19th
, please pick '1' time below.
Choose
8:00-8:30
8:30 - 9:00
9:00 - 9:30
9:30 - 10:00
10:00 - 10:30
10:30 - 11:00
11:00 - 11:30
11:30 - 12:00
1:00 - 1:30
1:30 - 2:00
2:00 - 2:30
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: (First)
Primary parent for enrollment purposes.
Your answer
Parent Name: (Last)
Primary parent for enrollment purposes.
Your answer
Phone Number: (XXX) - XXX - XXXX
*
Your answer
Parent Email Address:
(Double check for errors)
Your answer
Other siblings in the district:
*
(if this item doesn't pertain to you mark with NA)
Your answer
Custody
Is there a custody or parenting agreement in place for the child?
Yes
No
Clear selection
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