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Kindergarten Pre-Registration
Kindergarten Pre-Registration
Please complete the form below. Required fields marked with an asterisk *
Child's First Name:
*
Answer Required
Child's Middle Name:
*
Answer Required
Child's Last Name:
*
Answer Required
Gender:
*
Answer Required
Male
Female
Birthdate:
*
Answer Required
Ethnicity:
*
Answer Required
Hispanic/Latino
Non-Hispanic/Latino
Race:
*
Answer Required
Please Select
American Indian or Alaskan Native
Asian
Black/African American
Multi-Racial
Native Hawaiian or Other Pacific Islander
White
Other
If Other or Multi-Racial Explain below:
Answer Required
In what township or borough do you reside?
*
Answer Required
Please Select
Beccaria Twp
Coalport Borough
Irvona Borough
Reade Twp
White Twp
What county do you live in:
*
Answer Required
Please Select
Clearfield
Cambria
Father's/Legal Guardian's Name:
Answer Required
Father Living?
Answer Required
Yes
No
If Deceased what was the date?
Answer Required
Father's Occupation?
Answer Required
Father's Last Grade completed in school?
Answer Required
Mother's/Legal Guardian's Name:
Answer Required
Mother's Maiden Name:
Answer Required
Mother Living?
Answer Required
Yes
No
If Deceased what was the date?
Answer Required
Mother's Occupation?
Answer Required
Mother's Last Grade completed in school?
Answer Required
Address (physical and mailing) If a resident of Glendale Yearound, please provide lot number below:
*
Answer Required
Telephone #
Number Required
Email:
Answer Required
Step-Parent (s) name if applicable:
Answer Required
Step-Parent (s) Living?
Answer Required
Yes
No
If deceased what was the date?
Answer Required
Step-Parent (s) Occupation:
Answer Required
Step-Parent (s) grade completed in school:
Answer Required
Name/Address of second parent if separated or divorced:
Answer Required
Telephone:
Number Required
Guardian's Name:
Answer Required
Guardian Living?
Answer Required
Yes
No
If deceased what was the date?
Answer Required
Guardian's Occupation?
Answer Required
Guardian's Last Grade completed in high school:
Answer Required
Students in Family Household PLEASE PROVIDE: Name/Age/Gender/Living at home or college/Grade in school/Relationship to Student
Answer Required
Names of Others living in Household PLEASE PROVIDE: Relationship to Student/Age
Answer Required
Are Parents Separated?
Answer Required
Yes
No
Are Parents Divorced?
Answer Required
Yes
No
All Legal custody papers must be filed at the school
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