GSW Pre-K Interest Form

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College of Education
800 GSW State University Drive
Americus, GA 31709-4379
Education Center
phone: 229-931-2146
fax: 229-931-2163

GSW Pre-K Interest Form

Student/Child Information

Please select the school year in which you wish to enroll your student:

First Name:

Middle Name:

Last Name:

Race/Ethnicity:

Date of Birth:

Gender:

Mailing Address:

Street:

City:

State:

Zip:

Emergency Phone Number:

Student Lives With:

Parent/Guardian Information

Are you GSW University Faculty or Staff?:

Parent 1

First Name:

Middle Name:

Last Name:

Email Address:

Is the Address of the Child and 1_st Parent the Same?:

Mailing Address:

Street:

City:

State:

Zip:

Cell Number:

Work Number:

Parent 2

(not required)

First Name:

Middle Name:

Last Name:

Is the Address of the 1_st and 2_nd Parent the Same?:

Mailing Address:

Street:

City:

State:

Zip:

Cell Number:

Work Number:

Acknowledgment

This form only notifies GSW of your interest.

Registration information will be sent in the last week of January. Children of GSW faculty and staff are guaranteed placement. If the amount of interest forms for each school year exceeds 40, a lottery for enrollment will be used. Interest forms must be received by January 31 of the eligible year to be considered for the lottery.

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