2026-2027 Peer Model Pre-School Student Information Form

Surveys will close on February 9th

Parent(s) Name: * This field is required

Street: * This field is required

City: * This field is required

State: * This field is required

Zip: * This field is required

Cell Phone Number: * This field is required

Contact Email Address: * A valid email address is required

Child's Name: *

This field is required

Child's Date of Birth (Month/Day/Year): *

This field is required

Please list the names and grade levels of siblings currently attending Arlington (if any): * This field is required

Gender: * This field is required

Are you a resident of Arlington Local School District? **You must be an Arlington Local School District resident to attend** * This field is required

Class Preference: * This field is required

Enter the text you see in the security image:

336 South Main Street
Arlington, Ohio 45814