Preschool Information 2022-2023

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This form is for families that were not able to attend one of our preschool clinics in March. This will be used to reserve a spot in our preschool program next school year. You will be notified by mail on or before May 20th of your acceptance.

Email *

Student's Legal Name *

Student's Date of Birth *

YYYY

Student Gender *

Male

Female

Is student Hispanic? *

Yes

What is the student's race? *

African American

American Indian

Alaska Native

Asian

Native Hawaiin

Pacific Islander

White

Other:

Does the student live in-district ? *

Yes

Not sure

Does the student have an IEP (Individualized Educational Plan)? *

Yes

Does the student have a 504?

Yes

Clear selection

What is the t-shirt size of your student (youth sizes)? *

XXL

Name of Parent/Guardian Student Resides with: *

Home address: *

Mailing address (can skip if it is the same as home address)

Home Phone Number *

Cell Phone Number

Are any parents in the military? *

Active

Reserved

Names/Grade Levels of siblings:

Preferred Preschool Session: *

Morning

Afternoon

No preferece

Is your student wanting to attend Shining Stars? (this is a care session offered either in the morning or afternoon during school hours - when your student is not in preschool. There is a fee.) *

Yes

Maybe

Is your student wanting to attend Cares Club? (this is a care session offered after school until 6:00 pm. There is a fee.) *

Yes

Maybe

Was one of the parents a teen at the time of the student's birth? *

Yes

Does Parent #1 have a HS diploma or GED? *

Yes

Does Parent #2 have a HS diploma or GED? *

Yes

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