Kindergarten Registration

Liberty-Benton Elementary School
2009-2010 Kindergarten Registration

Parent's Name:

Address:

City: ,OH Zip

Phone Number:

Email Address:

Child's Name:

Childs Date of Birth:

Screening_Time Please select the desired time slot below to schedule you child's screening time.
Screening will be held on Thursday April 2nd, 2009.

NOTE: You will be contacted with the actual screening time.

8:30am-9:30am            12:30pm-1:30pm

9:30am-10:30am          1:30pm-2:30pm

10:30am-11:30am        2:30pm-3:30pm

Please bring the following items along with your child to the screening on April 2nd, 2009:

1. Child's birth certificate (hospital record is not acceptable).
2. Social Security Card.
3. Immunization (Shot) Records.
4. Any court documents pertaining to your child (custody).