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APPLICATION for consideration in USD 417 4-Year-Old Pre-K
*Please answer each question. Completion of the application determines your child's eligibility for the program. (This form does not need to be completed for Birth to Age 3 screenings.)
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Email
*
Your email
Child's First and Last Name
*
Your answer
Child's Date of Birth
*
MM
/
DD
/
YYYY
Will your child be 4 before September 1, 2024?
*
Yes
No
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