JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Haverhill Cooperative School District Preschool Program
Additional Information: School Year 2020-2021
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Student First & Last Name
*
Your answer
Date of Birth
*
MM
/
DD
/
YYYY
Please choose one:
*
Male
Female
Prefer not to say
Other:
Three Year Old Program (must be three by October 1st)
*
AM
PM
Four Year Old Program (must be four by October 1st)
*
AM
PM
Toilet Training?
*
Independent
In Progress
Not Yet
If not yet, please explain:
Your answer
Favorite Toys/Books/Activities:
*
Your answer
Fears:
*
Your answer
Developmental Concerns (If any)
Your answer
Date of completion of this form
*
MM
/
DD
/
YYYY
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of School Administrative Unit # 23.
Report Abuse
Forms
