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Moonachie School District Pre-K Registration Form
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* Indicates required question
Registration Date
*
MM
/
DD
/
YYYY
Student's First Name
*
Your answer
Student's Middle Initial
*
Your answer
Student's Last Name
*
Your answer
Student's Birth Date
*
MM
/
DD
/
YYYY
Student's Gender
*
Female
Male
Student's Ethnicity
*
White
Black
Asian
Hispanic
American Indain/Alaskan
Hawaiian Islander/Pacific Islander
Student's Birth City
*
Your answer
Student's Birth State
*
Your answer
Student's Birth Country
*
Your answer
Student's Entry Date in the United States (if not a natural born citizen)
MM
/
DD
/
YYYY
Primary Language spoken at home
*
Your answer
Secondary Language spoken at home
Your answer
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