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22-23 KG Round Up Online Registration
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* Indicates required question
Student Information
Student First Name (as it appears on student's birth certificate)
*
Your answer
Student Middle Name
*
Your answer
Student Last Name
*
Your answer
Birthdate
*
MM
/
DD
/
YYYY
Gender
*
Choose
Male
Female
Do you live in Eastbrook District?
*
Choose
Yes
No
Not Sure
Is your student currently enrolled in a Pre-School?
*
Yes, Eastbrook North (Mrs. Bryant)
Yes, Eastbrook North (Mrs. Myers)
Yes, Eastbrook South (Mrs. Gault)
No
Other:
For what school are you registering?
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Choose
Eastbrook North Elementary
Eastbrook South Elementary
Ethnicity (Hispanic/Latino)?
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Choose
Yes
No
Federal Race
*
American Indian or Alaskan Native
Asian
Black or African American
Native Hawaiian or Other Pacific Islander
White
Required
What is your home language?
*
Your answer
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