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4 and 5 year old School Readiness Registration 2021-2022
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* Indicates required question
Student's Last Name
*
Your answer
Student's First Name
*
Your answer
Middle Name
*
Your answer
Birth Date
*
MM
/
DD
/
YYYY
Gender
*
Female
Male
Prefer not to say
Other:
Grade
*
4 years old by September 1, 2020
5 years old by September 1, 2020 (and not attending Kdgn)
Ethnicity: (State of MN Mandate)Is this student Hispanic/Latino? (Cuban, Mexican, Puerto Rican, South/Central American or other Spanish culture or origin regardless of race)
*
Yes
No
Student's Race: (choose all that apply)
*
American Indian/Alaskan Native
Asian
Native Hawaiian/Pacific Islander
Black, Afterican American
White, not of Hispanic Origin
Required
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