2017-2018 KINDERGARTEN ENROLLMENT SURVEY FORM
 
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 Welcome to Kindergarten! 
If you have a child who will be five years of age on or before October 1, 2017, please complete the following:

 
1.
*
(LAST, FIRST, MIDDLE INITIAL)
 
   
2.
*
 
   
3.
*
 
   
Gender:  
   
4.
*
LAST, FIRST, MIDDLE INITIAL
 
   
5.
LAST, FIRST, MIDDLE INITIAL
 
   
6.
*
 
   
7.
*
 
   
8.
 
   
9.
*
NUMBER, STREET
 
   
10.
 
   
11.
(If you are not certain which school your child will attend, please contact Patricia Dyer at the Medford Board of Education Office at 609-654-6416, ext. 8001 for assistance.)
 
   
 
 
 
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