EARLY PREK-PREK
Pre-Registration
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Email *
PARENT-GUARDIAN NAME *
CHILD'S INFORMATION
You must fill out the following information about your child.
FULL LEGAL NAME AS SHOW ON BIRTH CERTIFICATE *
DATE OF BIRTH *
MM
/
DD
/
YYYY
CHOOSE WHICH OF THE PREK PROGRAMS YOU ARE INTERESTED IN REGISTERING YOUR CHILD
*
Required
GENDER *
RACE (AMERICAN INDIAN, WHITE, ASIAN, BLACK OR AFRICAN AMERICAN, ETC.) *
HISPANIC *
TRIBAL AFFILIATION
CHILD RESIDES WITH *
PRIMARY LANGUAGE SPOKEN IN HOME *
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