transitional kindergarten registration checklist

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1990 Linden Road West Sacramento, CA 95691

916-371-9416 Fax 916-371-1319 www.olgwestsac.com

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TRANSITIONAL KINDERGARTEN REGISTRATION CHECKLIST Forms accessed on the web may also be filled using your home computer; however, NONE of this information is saved, nor can it be sent electronically, so please PRINT a second copy for your records.

FAMILY NAME SCHOOL YEAR REQUIRED DOCUMENTS In an effort to streamline the Kindergarten Registration process, please fill, print out, and attach all forms listed below PRIOR TO submission and registration night. For the benefit of your child, ensure ALL information is printed legibly. Thank you.

OLG Standard Registration Packet (obtain from OLG website Home Page) This Transitional Kindergarten Supplemental Registration Packet Copy of Student's Birth Certificate Copy of Student's Immunization Record Copy of Student's Baptismal Record (if Catholic/Christian Denomination) Registration Fee of $325.00/student; checks made payable to OLG School

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1990 Linden Road West Sacramento, CA 95691

916-371-9416 Fax 916-371-1319 www.olgwestsac.com

Print Form

TRANSITIONAL KINDERGARTEN REGISTRATION FORM Forms accessed on the web may also be filled using your home computer; however, NONE of this information is saved, nor can it be sent electronically, so please PRINT a second copy for your records.

FAMILY NAME STUDENT INFORMATION:

SCHOOL YEAR F

NAME

M

Catholic D.O.B.

Birthplace:

Address: Attended PreSchool

Home Phone:

Name of School:

Baptismal Date:

MAIN FAMILY EMAIL: Church:

City, State:

PARENT/GUARDIAN INFORMATION Birthplace:

FATHER

Home No.

Work No.

Cell No.

Address City

State

Zip Code

Religion:

Occupation:

MOTHER

Birthplace:

Home No.

Work No.

Cell No.

Address City

State

Zip Code

Religion:

Occupation:

GUARDIAN:

Birthplace:

Home No.

Work No.

Cell No.

Address City

State

Religion: FOR OFFICE USE ONLY Check Receipt of:

Zip Code Occupation:

State Issued Birth Certificate

Baptismal Certificate

Immunization Record

Physical

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1990 Linden Road West Sacramento, CA 95691 916-371-9416 Fax 916-371-1319 www.olgwestsac.com

DENTAL EXAMINATION REPORT Forms accessed on the web may also be filled using your home computer; however, NONE of this information is saved, nor can it be sent electronically, so please PRINT a second copy for your records.

FAMILY NAME:

SCHOOL YEAR:

F

Student:

Grade:

M

Address:

Home Phone:

DENTAL REPORT Dentist: Please briefly report overall condition of child's teeth on most recent examination

Has all necessary dental work been completed?

Yes

No (Please explain below)

Please include any special recommendations or additional comments as well.

Dentist's Printed Name Office Number

Office Address City

Dentist's Signature

State

Zip Code

Date 011712tsv

Insert following documents in the order listed: Copy of State Issued Birth Certificate Copy of Immunization Records Copy of Baptismal Certificate CA State Form PM 171: Report of Health Examination for School Entry

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