Children registering for Pre-K must be age 4 on or before August 15, 2020.

To complete registration, you must provide the following:
-Child's birth certificate (state-certified copy)
-Immunization Form
-Proof of Income
-S.S. Card (optional but requested)
-Custody documents (if applicable)
-Copy of TNCare card (if applicable)
-Proof of Residence

Once the survey is complete, you will be contacted to submit the forms listed above.  Enrollment will not be processed until all forms are turned in to the school.

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* 1. Student's First Name (as it appears on the Birth Certificate)

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* 2. Student's Middle Name (as it appears on the Birth Certificate)

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* 3. Student's Last Name (as it appears on the Birth Certificate)

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* 4. Child's preferred name or nickname

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* 5. Student's Date of Birth:  MM/DD/YYYY

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* 6. Student's Gender

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* 7. Place of Birth (City and State)

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* 8. Mother's Maiden Name

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* 9. Student's Race (based on inherited physical characteristics)

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* 10. Student's Ethnicity

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* 11. Street Address

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* 12. City

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* 13. Zip Code

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* 14. Mailing Address (if different)

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* 15. Residence Information: Where does your child stay at night?  Please choose one.

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* 16. What is the first language your child learned to speak?

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* 17. What language is spoken most often when at home?

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* 18. What language is spoken most often outside of school?

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* 19. Name(s) of Custodial Parent/Guardian

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* 20. Parent/Guardian Address is the same as listed above for student

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* 21. Parent/Guardian Cell Phone Contact Number(s)

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* 22. Parent/Guardian Home Phone

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* 23. Parent/Guardian Work Contact

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* 24. Does the parent/guardian presently serve in the following?

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* 25. Emergency Contact (other than parent or guardian)

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* 26. Names of Siblings in home

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* 27. Does your child reside in the city limits of Etowah?

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* 28. Does your child currently receive Special Education services or any other type of services?

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* 29. Is your child a U.S. Citizen?

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* 30. My child receives books from the Imagination Library.

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* 31. Does your child currently have a device at home that allows him/her to access the internet (iPad, laptop, etc.)?  Please answer for the device, even if you do not have an internet connection.

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* 32. Does your child have access to a high-speed internet connection at your residence? 

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* 33. Non-Custodial Parent Information (if applicable)

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* 34. If there are custody restrictions, please describe here and present legal documents for the student's file

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* 35. Student's Doctor's Information

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* 36. Student's Dentist Information

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* 37. Please list any medical problems or allergies:
Type NA or None if there are no problems or allergies.

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* 38. Does your child have TNCare? (if yes, extra services may be available)

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* 39. Does your child have any previous Pre-K experience?

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* 40. Please check that you understand the following Pre-K attendance statements:

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* 41. Please check the following.

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