Mansfield Spanish Immersion - An International Spanish Academy Kindergarten Application 2017-2018
                                                Open Enrollment Available for all Eligible Students
                                              (If outside the district, families provide transportation)
                                                    Telephone: 419-525-6321   Fax: 419-525-6386
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1. Student's Name *
(First Name  Middle Initial  Last Name)
2. Date of Birth *
MM
/
DD
/
YYYY
3. Gender *
4. Parents' Name (Mother) *
Mother/Guardian
5. Parents' Name (Father) *
Father/Guardian
6. Address *
7. Phone (Home)
Phone (Cell)
8. E-mail
9. Residential School District *
10. Where has your child attended pre-school? *
11. Does your child speak a language other than English? *
If yes, what language?
12. What language is mainly spoken at home? *
13. What are the goals you have for your child in this program? *
14. When would you like to schedule a tour of the school and classrooms? *
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