• Early Childhood/Verona Area First Five Years/Pre-K Request for Assistance Form

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  • Child, Family, and Child Care Information


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  • Parent/Guardian Information

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  • Secondary Parent/Guardian Information

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  • Sibling Information

  • Information about Child and Concern(s)

  • Temperment Traits

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  • For each area of development selected above, please fax reports to 844.787.4713, Attn: Rachelle McCullough.

  • Electronic Signature

    The electronic signature below and its related field(s) are treated by Verona Area School District like a handwritten signature on a paper form (Board Policy 773, Use of Electronic Signatures)
  • I agree that the information provided herein is complete and accurate. I understand that this information is being used by the Verona Area School District for the purposes of enrolling/potentially evaluating my child. I understand that incomplete or inaccurate information may delay, prevent or invalidate my child's enrollment in school. I agree to promptly inform Verona Area School District of any changes to this information, including any changes in residence of my child.

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