OABCIG Preschool Student Information Form 2022-2023
1.Your child must be age 4 by 9/15/2023.
2. PLEASE NOTE: March 20 and March 24  - 8:00am - 7:00pm  are days to drop off a copy of your child's immunizations and birth certificate at the school. The district will email you a reminder as we get closer to these dates.
3. Please fill in the following information.
Email *
 Student Name (Legal Full Name - First, Middle, Last) *
What is your child's preferred name -the name teachers and staff will use to address your child? *
Date of Birth *
MM
/
DD
/
YYYY
Parent/ Guardian Name 1 *
Parent/ Guardian Name 2 *
Address (Parent/Guardian 1) *
Address (Parent/Guardian 2) (type NA if Not Applicable) *
Phone number (Parent/ Guardian 1) *
Phone number (Parent/ Guardian 2) *
Phone number (Other) (type NA if Not Applicable) *
How will your child get home after school? *
If your child attends daycare center, what is the address, phone number, and name of daycare?(type NA if Not Applicable) *
If your child will be picked up, who has permission to pick them up? Please list first name and last name,  and a contact number if other than parents. (Type NA if this is Not Applicable) *
Please list an emergency Contact 1 ( someone other than parents) *
Please list an emergency Contact 2 ( someone other than parents)
Does your child have any Medical Conditions we should be aware of? *
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