USD 490 Kindergarten PRE-Enrollment 2022-23
Please complete this electronic form to start the pre-enrollment process for the 2022-23 Kindergarten class.

Submitting this form is acknowledgement that you have completed this information to the best of your ability. Please note that incorrect information may slow your student's pre-enrollment process.

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STUDENT'S FULL LEGAL LAST NAME *
STUDENT'S FULL LEGAL FIRST NAME: *
STUDENT'S FULL LEGAL MIDDLE NAME:
STUDENT'S BIRTH DATE:
MM
/
DD
/
YYYY
STUDENT'S HOME ADDRESS: *
ARE YOU A RESIDENT OF USD490? *
PLEASE SELECT YOUR CHILD'S RESIDENCE SCHOOL: *
MOTHER/GUARDIAN FULL NAME:
MOTHER/GUARDIAN EMAIL ADDRESS:
MOTHER/GUARDIAN HOME ADDRESS:
MOTHER/GUARDIAN CELL PHONE:
MOTHER/GUARDIAN HOME PHONE:
MOTHER/GUARDIAN EMPLOYER:
MOTHER/GUARDIAN WORK PHONE:
FATHER/GUARDIAN FULL NAME:
FATHER/GUARDIAN EMAIL ADDRESS:
FATHER/GUARDIAN HOME ADDRESS:
FATHER/GUARDIAN CELL PHONE:
FATHER/GUARDIAN HOME PHONE:
FATHER/GUARDIAN EMPLOYER:
FATHER/GUARDIAN WORK PHONE:
PLEASE INDICATE WITH WHOM THE STUDENT LIVES:
PLEASE INDICATE WHO HAS LEGAL CUSTODY OF THE STUDENT:
PLEASE LIST ANY SIBLINGS OF THIS STUDENT (NAME, GRADE/AGE IF PRESCHOOLER, CURRENT SCHOOL):
WHAT DO YOU WANT US TO KNOW ABOUT YOUR CHILD?
LIST NAME OF PERSON COMPLETING THIS FORM AND THEIR RELATIONSHIP TO THE STUDENT: *
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