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Kindergarten Registration
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* Indicates required question
Name (First, Middle, Last)
*
Your answer
Gender
*
Female
Male
Date of Birth
*
MM
/
DD
/
YYYY
Race/Ethnicity
Black/African American
Hispanic/Latino
Asian
Native Hawaiian/Pacific Islander
Native American
White/Caucasian
Clear selection
Is anyone in the household active military
*
Yes
No
Student born in the United States
*
Yes
No
Address
*
Your answer
City
*
Your answer
Phone Number
*
Your answer
Parent(s)/Guardian Name
*
Your answer
Parent(s)/Guardian Email Address
*
Your answer
Preschool Attended
*
Your answer
School District of Residence
*
In West Washington School District
Out of West Washington School District
If immunizations are offered the day of registration
*
Yes, I would like my child to receive kindergarten immunizations at registration
No, I do not want my child to receive kindergarten immunizations at registration
If you wish to receive immunizations at registration please select the type of insurance you have. (Bring your insurance card with you the day of registration)
Medicaid
Private Insurance
Other:
Clear selection
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