KINDERGARTEN SCREENING SIGN UP FORM
EASTWOOD LOCAL SCHOOLS 2023-2024

Dear Parents, 

Eastwood Local Schools will provide Kindergarten screening for the 2023-2024 school year.  Screening dates will be April 14, 2023, April 17, 2023 and April 18, 2023.  Times will be 8:30 a.m., 10:15 a.m. and 1:00 p.m. each day.
Screening will be held at the Eastwood Central Office (The old Pemberville Elementary) 120 E. College Avenue, Pemberville, OH  43450.

District Policy states the child must be five (5) years old on or before August 1st.

If you have a child who will be attending Kindergarten in the upcoming school year, please complete this screening request.  This should be completed no later than March 1, 2023.

You will be notified of your child's screening date and time by US Mail, along with a packet of information and forms to be completed and returned the day of the screening.  Please note that efforts will be made to honor your date and time request, however this may not be possible due to the volume of the requests for a given time and day.

COMPLETE THIS FORM ONLY.  DO NOT INPUT YOUR CHILD INTO FINAL FORMS.


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Child's Last Name *
Child's First Name *
Child's Middle Name *
Child's Date of Birth (mm/dd/yyyy) *
MM
/
DD
/
YYYY
Child's Gender *
Name of Parent/Legal Guardian with Whom the Child Resides *
Street Address *
PO Box Number (if applicable)
City *
State *
Zip Code *
Telephone Number (123-123-1234) *
Open enrollment form needed? *
Email address *
Please select the screening date you prefer. *
Please select the screening time you prefer.
 *
Preschool attended AND number of years attended *
Check the box below to serve as your digital signature *
Required
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