Rock County Public Schools
Preschool Application

If you have any questions or concerns please email Miss Harlee at hgentele@rockcountyschools.org

You will be notified before May 31st if your child has been accepted!
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Date of Application *
YYYY
/
MM
/
DD
Students Legal Full Name Last, First, Middle *
Date of Birth *
Gender *
Custodial Parent/Guardian Full Names: *
District child reside in *
Mailing Address *
Parent/guardian email *
List younger siblings and birthdates in household *
Who Has Custody *
必須
Any Special Services student receives:
Emergency Medical Conditions/Problems of Student: Check all that Apply *
必須
Parent/Guardian Signature                                         (Please Type First and Last Name) *
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