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Parents as Teachers USD 465 Enrollment
Are you interested in being in the Parents as Teachers program? Please complete this form and someone will contact you soon with more information.
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* Indicates required question
Parent/Guardian Name
*
Your answer
Parent/Guardian date of birth
*
MM
/
DD
/
YYYY
Race
American Indian/Alaska Native
Asian
Black or African American
Native Hawaiian
Other Pacific Islander
White
More than one race
Prefer not to report
Other
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Ethnicity
Hispanic or Latino/a/x
Not Hispanic or Latino/a/x
Prefer not to report
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What is the primary language spoken in your home?
Your answer
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