Basin School District Preschool Registration 2024-2025

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

If this is your first time enrolling a child at Basin, we would like to extend a warm welcome! Please use this form to start the registration process for your preschool student. To be eligible for the Basin Preschool program, students must either be 4 years old by September 1, 2024 OR be 3 years old and be eligible for special education services. If you have a three year old that is eligible for services through the Department of Health and Welfare's Infant Toddler program, indicate so below. Also, if you have concerns about your 3 year old's development in speech/language, motor skills, social skills, or behavior, please fill out the form below and mark your concerns. Once this form is submitted, we will contact you with additional information and paperwork. If you have additional questions, you can also contact Principal, Jamie Pilkerton at jpilkerton@basinschools.net.

Email *

Student's First Name *

Student's Middle Name

Student's Legal Last Name *

Student's Date of Birth *

YYYY

Student's Gender

Mother's Full Name *

Mother's Email Address *

Mother's Phone Number

Father's Full Name *

Father's Email Address

Father's Phone Number

Student's Primary Home Mailing Address *

Student's Primary Street Address *

City, State, Zip Code of Address *

Which area of the district does your child live?

Idaho City Area (including subdivisions north of Idaho City and south down to Pine Top)

Duquette

Centerville/Placerville

Hwy 21

Clear Creek

Osprey

Wilderness Ranch

Robie Creek

Mores Creek Rim Ranch Area

Other:

Clear selection

Which response best matches your child's living arrangement. *

Lives with both mother and father in same household.

Lives with both mother and father but in two separate households.

Lives only with mother during the school year.

Lives only with father during the school year.

Clear form

Never submit passwords through Google Forms.

This form was created inside of Basin School District.

Does this form look suspicious? Report

Forms