2020 Extended Day and After School Program Registration

您的浏览器中未启用 JavaScript，因此无法打开此文件。请启用 JavaScript，然后重新加载。

Please use this form to register for the 2020 Extended Day and After School Programs at McKinley and Meadow View School

电子邮件地址 *

Student's First Name *

Student's Last Name *

Student's Birthdate *

年

月

日

Student's Age *

Student's Grade *

Kindergarten

First

Second

Third

Fourth

Fifth

Street Address *

City, State, Zip Code *

Parent/Guardian Name (First and Last) *

Daytime Phone Number *

Relationship *

Parent

Guardian

Foster Parent

其他:

Cell Phone Number *

Place of Employment *

Additional Parent/Guardian Name (First and Last)

Relationship

Parent

Guardian

Foster Parent

其他:

清除所选内容

Daytime Phone Number

清除表单内容

切勿通过 Google 表单提交密码。

此表单是在 Lassen County Office of Education 内部创建的。举报滥用行为