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First United Methodist Preschool Application 2021-2022
*UPDATE 2/16/21* Our pre-K and 3's classes are nearing capacity. You may be waitlisted. Our staff will contact you to let you know if you waitlisted and what number you are on that list.
Our 2s class is still enrolling!
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Email
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Your email
Child's Name:
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Your answer
Preferred Name (if different):
Your answer
Class:
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2 year olds (age 2 by September 30) TUES and THURS. 9:00am-12:00pm $240/month with yearly $100 Activity Fee.
3 year olds (age 3 by September 30) MON, WED, and FRI 9:00am-12:00pm $290/month with yearly $150 Activity Fee
4 year olds/PreK (age 4 by September 30) MON-FRI 9:00am-12:00pm $390/month with yearly $200 Activity Fee.
Date of Birth:
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MM
/
DD
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YYYY
Gender:
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Female
Male
Primary Phone:
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Your answer
Home Address:
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Your answer
Has your child attended preschool or childcare before?
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Yes
No
If yes, what preschool or childcare center and for how long?
Your answer
How did you hear about First United Methodist Preschool?
Your answer
Parent/Guardian #1 Name:
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Your answer
Parent/Guardian #1 Address:
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Your answer
Parent/Guardian # 1 Phone and Email:
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Your answer
Parent/Guardian #1 Occupation:
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Your answer
Parent/Guardian #2 Name:
Your answer
Parent/Guardian #2 Address (if different):
Your answer
Parent/Guardian #2 Phone and Email:
Your answer
Parent/Guardian #2 Occupation:
Your answer
Name and age of other children in your family:
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Your answer
Emergency Contact #1 (in case parent cannot be reached):
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Your answer
Emergency Contact #1 Address and Phone:
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Your answer
Emergency Contact #1 Relationship to Child:
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Your answer
Emergency Contact #2:
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Your answer
Emergency Contact #2 Address and Phone:
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Your answer
Emergency Contact #2 Relationship to Child:
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Your answer
Health Information (please complete in detail)
Does your child have any known environmental, food, or insect allergies or special health conditions?
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Yes
No
If yes, please explain in detail:
Your answer
Do your child's allergies or special health conditions require preschool staff to monitor for symptoms, take action if a reaction occurs, or give emergency medication to your child?
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Yes
No
Other:
If yes, an Emergency Care Plan or equivalent form must be completed.
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I will provide FUMP with a detailed Emergency Care Plan developed with my child's physician.
NA
Does your child have any non-allergy dietary needs?
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Your answer
Has your child ever been evaluated for or received services for speech or developmental delays? If yes, please explain:
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Your answer
Preferred Hospital:
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University of Virginia
Sentara Martha Jefferson
Primary Care Physician/Pediatrician and Practice:
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Your answer
Tell us about your child!
Please describe your child using three words.
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Your answer
What is your family's favorite activity to do together?
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Your answer
What makes your child feel happy?
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Your answer
What makes your child feel frustrated?
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Your answer
What is your child's favorite book or toy?
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Your answer
What else would you like us to know about your child?
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Your answer
You are almost done!
All applications require a non-refundable $50 application fee. You may submit this fee via check to First United Methodist Preschool or via Venmo to @FUMP-payments.
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I am submitting a check (please send to FUMP 101 East Jefferson Street, Charlottesville, VA 22902)
I am submitting the fee via Venmo (@FUMP-payments)
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