Enrollment Form

Enrollment Form

Mother's First and Last Name ***

Father's First and Last Name **

Address *

City 

State 

Zip Code 

Phone 1 

Phone 2 

Email Address 

Are you a first-time parent? *

Race/Ethnicity 

Language spoken 

Insurance 

Child 1 First and Last Name 

Child 1 Birthdate 

Child 1 Gender 

Child 1 Ethnicity 

Developmental Concerns 

 

Child 2 First and Last Name 

Child 2 Birthdate 

Child 2 Gender 

Child 2 Ethnicity 

Developmental Concerns 

Child 3 First and Last Name 

Child 3 Birthdate 

Child 3 Gender 

Child 3 Ethnicity 

Developmental Concerns 

School District **Hancock 

What are the best times and days for a personal visit?  (Check all that apply)

Morning   Afternoon   Evening   Mon   Tues   Wed   Thurs   Fri   Sat

Do all parents/guardians work outside the home?  Yes  No

Does your child attend preschool or child care?  If so, where and since what age?

 



Security Measure

Hancock Place School District does not discriminate on the basis of race, color, national origin, sex, age, or disability in admission to its programs, services, or activities, in access to them, in treatment of individuals, or in any aspect of their operations. The lack of English language skills shall not be a barrier to admission or participation in the district’s activities and programs. Hancock Place School District also does not discriminate in its hiring or employment practices.

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