2022-2023 Peer Model Pre-School Student Information Form

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2022-2023 Peer Model Pre-School Student Information Form

Cory-Rawson Local Schools

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* Indicates required question

Email *

Your email

Parent(s) Name: *

Your answer

Street *

Your answer

City *

Your answer

Zip *

Your answer

Cell Phone Number *

Your answer

Child's Name *

Your answer

Child's Date of Birth (Month/Day/Year) *

MM

/

DD

/

YYYY

Please list the names and grade levels of siblings currently attending Cory-Rawson (if any): *

Your answer

Gender *

Male

Female

Are you a resident of Cory-Rawson Local School District? *

Yes

No

Class Preference: *

AM

PM

A copy of your responses will be emailed to the address you provided.

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