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Pre-K Registration Packet Request Form

By filling out this form, you are requesting to receive a Pre-K Registration Packet by email. Please note that because Madison Elementary Pre-K is on a first-come, first-served basis, this request does NOT secure your child a spot in the preschool program. Your submission date/time will be recorded once the Preschool Registration Packet is returned on:

April 15, 2019 from 7:00am - 3:00pm.
*No registration packets will be accepted before this time.

Contact Information

Parent First Name*

Answer Required

Parent Last Name*

Answer Required

Child First Name*

Answer Required

Child Last Name*

Answer Required

Child's Birthdate*

Answer Required

Address

Street Address*

Answer Required

City*

Answer Required

Zip/Postal*

Answer Required

Home Phone

Answer Required

Mobile Phone*

Answer Required

Email *

Answer Required

Please allow 24-48 hours for our registrar to process your request.

Confirmation Email

Enter your email address here if you'd like to receive a confirmation upon submitting the form.

Email Required