* Required

Student Information

Student First Name*required

Student Preferred Name

Student Last Name*required

Birthdate*required (mm/dd/yyyy)

Interested in school year

2021-20222022-2023

Grade applying for*required

Please Select…PreKKindergarten12345678

Current Grade

PreschoolPreKKindergarten1234567

Current school name

Do you want to add another child?

Yes  No 

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Student 2 First Name*required

Student 2 Preferred Name

Student 2 Last Name*required

Birthdate Student 2*required (mm/dd/yyyy)

Interested in school year

2021-20222022-2023

Grade applying for Student 2*required

Please Select…PreKKindergarten12345678

Current Grade for Student 2

PreschoolPreKKindergarten1234567

Current school name for Student 2

Do you want to add a third child?

Yes  No 

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Student 3 First Name*required

Student 3 Preferred Name

Student 3 Last Name*required

Birthdate Student 3*required (mm/dd/yyyy)

Interested in school year

2021-20222022-2023

Grade applying for Student 3*required

Please Select…PreKKindergarten12345678

Current Grade for Student 3

PreschoolPreKKindergarten1234567

Current school name for Student 3

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Parent / Guardian Information

Parent 1 First Name*required

Parent 1 Last Name*required

Email*required

Mobile Phone*required

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Parent 2 First Name

Parent 2 Last Name

Email

Mobile Phone

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Address

Address 1

Address 2

City

State

Zip