2024-2025 EECC Enrollment Form

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Thank you for your interest in enrolling your student at Edgewood Early Childhood Center for the 2024-2025 school year! Please complete all sections of the following form to tell us more about the preschool student you would like to enroll. If you are enrolling more than one student, please complete multiple enrollment forms. When you submit the enrollment form, you will receive confirmation that it has been sent.

Email *

Student Last Name: (Legal name on birth certificate) *

Student First Name: (Legal name on birth certificate) *

Student Middle Name: (Legal name on birth certificate) *

Does your child go by another name? Please enter, if no please leave blank.

Student's Gender *

Male

Female

Student's Race *

American Indian or Alaskan

Asian

Black or African American

Native Hawaiian or Other Pacific Islander

White

Student's Race/Ethnicity: Is your student Hispanic or Latino? *

Yes

Student Date of Birth: *

YYYY

Are you, as a parent or guardian, a current Richland-Bean Blossom Community School Corporation employee? *

Yes

Does your student already have an Individualized Education Program (IEP) in place? *

Yes

Does your student currently attend EECC? *

Yes

Does this student have a sibling who currently attends EECC (and who will still be attending next year)? *

Yes

Parent/Guardian Name 1 *

Parent/Guardian Email 1 *

Parent/Guardian Phone 1 (XXX-XXX-XXXX) *

Parent/Guardian Name 2

Parent/Guardian Email 2

Parent/Guardian Phone 2 (XXX-XXX-XXXX)

Does your student have siblings who currently attend Edgewood Schools? *

Yes

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