Kindergarten Interest Form 2020-2021 Have you pre-registered your child for Kindergarten with Brookline Public Schools? * Yes No Please enter the date of your child's registration appointment with the PSB. * MM DD YYYY Has your child been assigned to Driscoll School, or are you in a buffer zone? * My child has been assigned to Driscoll School. We live in a buffer zone. If you are in a buffer zone, please let us know the school(s) in your buffer zone. Example: Devotion/Driscoll Child's name * First Name Last Name Child's Date of Birth * MM DD YYYY Parent/Guardian Name * Please enter first and last name. Home Address * Email Address * Primary Phone * (###) ### #### Secondary Phone (###) ### #### Parent/Guardian Name Please enter first and last name. Home Address Email Address Primary Phone (###) ### #### Secondary Phone (###) ### #### We need extended day because: * Both parents working Single working Other (please explain) Other reason you need extended day: Do you have a child currently enrolled in DEDP? * Yes No Please select the days you are requesting for 2020-2021 * Must select a 2, 3, or 5 day option Monday Tuesday Wednesday Thursday Friday Important information, PLEASE READ. * I understand that if DEDP is oversubscribed a lottery will be held in April. You will be contacted about whether your child has been wait-listed or accepted into the program. The days I requested for the 2020-2021 school year will be the days entered in the case of a lottery. I understand Digital Signature * I understand that this is an interest form only and does NOT secure a spot for my child. Digital Signature * Please enter your first and last name as a digital signature. Thank you!
