JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Preschool Screening
Please fill out the form below to schedule a preschool screening appointment for your child. Once the form is submitted we will send paperwork and other information to you via mail. Thank you!
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
Parent/Guardian Name
Your answer
Child's Name
Your answer
Child's Date of Birth
Your answer
Contact Information (email or phone)
Your answer
Mailing Address
Your answer
Appointment Time - May 18th
9:00 AM
9:30 AM
10:00 AM
10:30 AM
11:00 AM
11:30 AM
12:00 PM
12:30 PM
1:00 PM
1:30 PM
2:00 PM
Clear selection
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Climax-Shelly School.
Does this form look suspicious?
Report
Forms
Help and feedback
Contact form owner
Help Forms improve
Report