West Hempstead UPK Interest Survey
Please complete this survey to express your interest in the new full day Universal PreK (UPK) Program being offered in the West Hempstead School District beginning in January 2022. The UPK Program is a lottery-based system. Further information about the lottery will be forthcoming. Eligible students must be West Hempstead residents and four years old by December 1, 2021. The program will run from 9:00 A.M. - 2:00 P.M. in the Chestnut Street School. Please complete this survey by December 17, 2021.
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Email *
Are you a West Hempstead resident? *
Student home address including city and zip code *
Student primary phone number including area code *
Student date of birth: month / day / year *
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Student Last Name *
Student First Name *
Parent/Guardian Last Name *
Parent/Guardian First Name *
Parent/Guardian primary email address *
If your child's name is not chosen out of the lottery, would you be interested in a tuition-based option? *
A copy of your responses will be emailed to the address you provided.
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