Golden Pass Program
Please correct the following errors.
First Name
Last Name
Email Address
Date of Birth
(MM/DD/YYYY)
Street Address
City
State
Zip Code
Phone Number
Would you like to also obtain a Golden Pass for your eligible spouse?
Yes
No
Spouse First Name
Spouse Last Name
Spouse Date of Birth
(MM/DD/YYYY)
How would you like to receive your pass(es)?
Mailed to me at the address above
Pick up in person at the District Central Office (located at 1099 Milwaukee St.)
What would you like to submit?
Question
Comment
Suggestion
Concern
Compliment
Tell us who you are
(Select one or more)
Kirkwood School District Student
Kirkwood School District Parent/Guardian
Kirkwood School District Employee
Community Member
Enter the characters as shown in the image
Enter the characters as shown in the image
Required
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