Kindergarten Registration Form
Dear Parent/Guardian,

We are currently developing plans for the registration of children who will be entering Allegheny-Clarion Valley in August 2020.

To be eligible to attend Kindergarten, a student must be 5 years old before July 1, 2020.  To enter first grade, a student must be 6.

****SPECIAL NOTE****

A child must have the following immunizations before he/she can enter school:
-MEASLES-MUMPS-RUBELLA (MMR) – 2 shots with the first one on or after 12 months of age
-DIPTHERIA-TETANUS (DT) – 4 shots with the 4th or 5th one on or after the 4th birthday
-POLIO (OPV/IPV) – 4 doses, the last dose on or after the 4th birthday and 6 months after previous dose
-HEPATITIS B (HBV) - 3 shots appropriately spaced
-VARICELLA – 2 shots with the first one on or after 12 months of age or written date of chicken pox disease

If your child is eligible to enter school and does not have the necessary immunizations within the first 5 days of school, your child will be excluded until the immunizations are completed. Please check with your family physician or the PA State Health Center to make arrangements to have these completed before the beginning of school.

If you have a child or know of any children who may be eligible for August 2020 please complete and submit the information form below.

Any questions concerning the above should be directed to Stacey Redding at the AC Valley Elementary Office at 724-659-3555.

Sign in to Google to save your progress. Learn more
Student's Full Name *
Boy or Girl: *
Student's Date of Birth *
MM
/
DD
/
YYYY
This registration is to enter: *
Name of Parent/Guardian: *
Street Address: *
PO Box (if applicable):
City, State, Zip Code: *
Telephone Number: *
Name of Sibling(s) and Grade (If applicable):
Please check the area in which the student lives: *
Required
How did you find out about this Child Identification Screening? *
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Allegheny-Clarion Valley School District. Report Abuse