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2025-2026 Southampton Township Public Schools Preschool Program Application
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* Indicates required question
Child's First Name
*
Your answer
Child's Middle Name
Your answer
Child's Last Name
*
Your answer
Child's Gender
*
Choose
Male
Female
Child's Date of Birth
*
MM
/
DD
/
YYYY
Child's Street Address
*
Your answer
Child's City
*
Your answer
Child's State
*
Choose
ALABAMA (AL)
ALASKA (AK)
ARIZONA (AZ)
ARKANSAS (AR)
AMERICAN SAMOA (AS)
CALIFORNIA (CA)
COLORADO (CO)
CONNECTICUT (CT)
DELAWARE (DE)
DISTRICT OF COLUMBIA (DC)
FLORIDA (FL)
GEORGIA (GA)
GUAM (GU)
HAWAII (HI)
IDAHO (ID)
ILLINOIS (IL)
INDIANA (IN)
IOWA (IA)
KANSAS (KS)
KENTUCKY (KY)
LOUISANA (LA)
MAINE (ME)
MARYLAND (MD)
MASSACHUSETTS (MA)
MICHIGAN (MI)
MINNESOTA (MN)
MISSISSIPPI (MS)
MISSOURI (MO)
MONTANA (MT)
NEBRASKA (NE)
NEVADA (NV)
NEW HAMPSHIRE (NH)
NEW JERSEY (NJ)
NEW MEXICO (NM)
NEW YORK (NY)
NORTH CAROLINA (NC)
NORTH DAKOTA (ND)
NORTHERN MARIANA ISLANDS (MP)
OHIO (OH)
OKLAHOMA (OK)
OREGON (OR)
PENNSYLVANIA (PA)
PUERTO RICO (PR)
RHODE ISLAND (RI)
SOUTH CAROLINA (SC)
SOUTH DAKOTA (SD)
TENNESSEE (TN)
TEXAS (TX)
TRUST TERRITORIES (TT)
UTAH (UT)
VERMONT (VT)
VIRGINIA (VA)
VIRGIN ISLANDS (VI)
OTHER
Child's Zip Code
*
Your answer
Parent/Guardian's Name
*
Your answer
Parent/Guardian's Email
*
Your answer
Parent/Guardian's Name
Your answer
Parent/Guardian's Email
Your answer
Home Phone
Your answer
Cell Phone
*
Your answer
If selected, will your child participate in our school bussing transportation program?
*
Yes
No
Maybe
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