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2021-2022 Country Trails Early Childhood Request Form
**Please note** Spots are collected on a first come first serve basis.
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* Indicates required question
Email
*
Your email
Student Name
*
Your answer
Date of Birth
*
MM
/
DD
/
YYYY
On September 1st will your child be?
*
3
4
Home School
*
Country Trails
Prairie View
Howard B. Thomas
Lily Lake (will attend Howard B. Thomas for Early Childhood)
Not Sure
Address
*
Your answer
Phone Number
*
Your answer
Email Address
*
Your answer
Do you have any concerns regarding your child?
*
Your answer
Is your child a new student or returning student?
*
New Student
Returning Student
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