UPK Pre-Registration

Page 1 of 1

UPK Pre-Registration Form

District families may use this form to share their interest in the Universal Pre-Kindergarten program offered by the Phelps-Clifton Springs Central School District for the 2021-2022 school year. To be eligible for UPK for the upcoming school year, a child must have a birthdate between December 2, 2016 and December 1, 2017.

	Preferred Time Slot*
	Preferred Time Slot* Full day Half day a.m. Half day p.m.

	Student Name*

	Date of Birth*

	Gender*

	Parents/Legal Guardians*

	Home Address (include complete information)*

	Phone Numbers*

	Home Language*

	Parent/Guardian Email Address (must be valid email address)*

	Additional Comments (rank preferred time slots, etc.)