Pre-K and Kindergarten Registration 2021-2022

*Please note, required fields are in red.

I am interested in receiving registration information for:	-- Choose One -- Pre-K Kindergarten
If Kindergarten:	-- Choose One -- Brookhaven Kindergarten Kreamer Street Kindergarten Verne Critz Kindergarten
Child’s Name:
Date of Birth:	RadDatePicker RadDatePicker Open the calendar popup. Calendar Title and navigation Title and navigation << < April 2024 > << April 2024   S M T W T F S 14 31 1 2 3 4 5 6 15 7 8 9 10 11 12 13 16 14 15 16 17 18 19 20 17 21 22 23 24 25 26 27 18 28 29 30 1 2 3 4 19 5 6 7 8 9 10 11
Parent Name:
Address:
(line 2)
City
State	-- Choose State -- Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming
Zip Code
Phone Number:
Email:
Additional comments:
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