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Preschool Application Form
Argos-Culver-Triton
Program is located at Argos Elementary
Due July 1, 2017
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This is an application.
Entrance into A.C.T Preschool is determined on student needs and class availability.
Student's First Name
*
Your answer
Student's Middle Name
*
Your answer
Student's Last Name
*
Your answer
Parent Email
Your answer
Birth date of Student- Child must be 3 by August 1 to attend
*
MM
/
DD
/
YYYY
Gender
*
Male
Female
Prefer not to say
Address (Street, City, State, Zip Code)
*
Your answer
Home Phone
*
Your answer
Primary Language
*
Your answer
Race/Ethnicity of student
*
White/Non-Hispanic
Hispanic
Black/Non-Hispanic
American Indiana/Alaskan
Multi-racial
Asian
Other:
School of Legal Settlement
*
Culver
Argos
Triton
Other:
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