Preschool Screening Sign Up Form

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YOUR CHILD MAY QUALIFY IF:
-- They live within the Walton-Verona School District and...
-- They are 3 or 4 years old and display difficulty in speech and/or problems attaining developmental skills that are needed to be successful in school
-- They are 4 years old by August 1st and the family qualifies financially
--They are 4 years old and interested in attending the preschool tuition program.

Child's First Name *

Child's Last Name *

Child's Birthdate *

YYYY

Address: Street, City and Zip *

Parent / Guardian: First Name *

Parent / Guardian: Last Name *

Parent / Guardian: Phone *

Parent / Guardian: Email *

Let us know if you have any questions below. You will be contacted by WVECC staff with more information on your screening appointment. Thank you!

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