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Preschool/Kindergarten Roundup Form
Please fill out this form if your child is going to be attending Kindergarten or 4-year-old Preschool with Centerville Community School District for the 2020-2021 School Year
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* Indicates required question
Which grade will your child be enrolling into
*
Preschool- 4 years old by September 15
Kindergarten- 5 years old by September 15
Parent/Guardian Name
*
Your answer
Child's Full Name
*
Your answer
Child's Date of Birth
*
MM
/
DD
/
YYYY
Gender
*
Male
Female
Address
*
Your answer
Phone Numbers
*
Your answer
Medical/Education Concerns
Your answer
Other- Any other information. Ex. Custody or Guardianship situations
Your answer
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