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GREENFIELD EXEMPTED VILLAGE SCHOOL DISTRICT 2020-2021 KINDERGARTEN/PRESCHOOL REGISTRATION FORM
FOR KINDERGARTEN: CHILD MUST BE FIVE BY 8/1/2020
FOR PRESCHOOL: CHILD MUST BE BETWEEN 3-5 YEARS OLD AND NOT ELIGIBLE FOR KINDERGARTEN
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Email
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CHILD'S FIRST, MIDDLE, AND LAST NAME: (EXACTLY AS SHOWN ON BIRTH CERTIFICATE)
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SCHOOL OF RESIDENCE:
GREENFIELD ELEMENTARY
BUCKSKIN ELEMENTARY
RAINSBORO ELEMENTARY
UNSURE
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SCHOOL YOU WOULD LIKE YOUR CHILD TO ATTEND: (UPON OPEN ENROLLMENT APPROVAL)
GREENFIELD ELEMENTARY
BUCKSKIN ELEMENTARY
RAINSBORO ELEMENTARY
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THIS REGISTRATION IS FOR:
KINDERGARTEN 2020-2021
AM RAINSBORO PRESCHOOL 2020-2021
AM GREENFIELD ELEMENTARY PRESCHOOL 2020-2021
PM GREENFIELD ELEMENTARY PRESCHOOL 2020-2021
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NAME CHILD GOES BY:
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ADDRESS: (STREET, CITY, STATE, ZIP CODE)
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COUNTY OF RESIDENCE:
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TELEPHONE NUMBER:
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CHILD'S SOCIAL SECURITY NUMBER:
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CHILD'S BIRTHDATE:
MM
/
DD
/
YYYY
CHILD'S GENDER:
MALE
FEMALE
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IS YOUR CHILD HISPANIC OR LATINO?
YES
NO
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WHAT IS YOUR CHILD'S RACE?
WHITE
AMERICAN INDIAN OR ALASKAN NATIVE
BLACK OR AFRICAN AMERICAN
ASIAN
NATIVE HAWAIIAN OR OTHER PACIFIC ISLAND
MULTIRACIAL
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IF CHILD IS MULTIRACIAL PLEASE PUT WHICH RACES:
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CHILD'S BIRTH CITY:
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FATHER: (FIRST, MIDDLE, AND LAST NAME)
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FATHER: (ADDRESS AND PHONE NUMBER IF DIFFERENT THAN ABOVE)
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MOTHER: (FIRST, MIDDLE, AND LAST NAME)
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MOTHER: (ADDRESS AND PHONE NUMBER IF DIFFERENT THAN ABOVE)
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MOTHER'S MAIDEN NAME:
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STEP-PARENT/GUARDIAN IF APPLICABLE: (FIRST, MIDDLE, AND LAST NAME)
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STEP-PARENT/GUARDIAN IF APPLICABLE: (ADDRESS IF DIFFERENT THAN ABOVE)
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CHILD LIVES WITH:
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PARENTS ARE:
MARRIED
LEGALLY SEPARATED
DIVORCED
NEVER MARRIED
MOTHER DECEASED
FATHER DECEASED
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NUMBER OF YEARS ATTENDED: PRESCHOOL SCHOOL
0
1
2
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NUMBER OF YEARS ATTENDED HEADSTART:
0
1
2
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MEDICAL PROBLEMS OR ISSUES:
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DOES YOUR CHILD HAVE ANY SPEECH ISSUES?
YES
NO
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IF YES, PLEASE DESCRIBE:
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HAS STUDENT PREVIOUSLY ATTENDED GREENFIELD SCHOOLS?
YES
NO
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IF YES- WHEN AND WHAT BUILDING
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PREVIOUS SCHOOL ATTENDED IF NOT A GEVSD SCHOOL
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