Preschool Registration Form

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Spring Preschool Registration will be open from March 1, 2024. Please complete the form below for Preschool Registration. The Preschool Coordinator will then contact you to schedule a time to complete the required paperwork and screening process with your child. If you have questions regarding Preschool Registration, please contact Mrs. Sampson, Preschool Coordinator at the administration offices 330-679-2343 ext. 4100 or by email at kristy.sampson@slindians.org . Please make sure to leave your name, child's name, and contact phone number. Thank you!

Email *

Child First and Last Name *

Parent or Guardian First and Last Name *

Address: *

Parent or Guardian Phone Number *

Child's Current Age *

3 Years Old ( if space allows)

4 Years Old

5 Years Old

Child's Birthdate *

YYYY

Has your child attended Preschool programming? *

My child attended Preschool at Southern Local.

My child attended Preschool at another location.

My child hasn't attended Preschool before.

Special Services

My child doesn't have an IEP requiring special services

My child has an IEP requiring special services

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Southern Local has 2 sessions for Preschool. Spots are reserved for children 4-5 years old. We will accept 3-year-old students if there are open spots after registration is complete. Session availability is on a first come first serve basis. Our Morning Half Day and Full Day classes are full. *

I would like my child to be on the Half Day Afternoon List (Monday-Thursday, no class Friday)

My child is 3 years old and I would like to be on the wait list for available spots

Preschool students are required to have an up to date shot record and well visit that was completed in the last year. Please enter the date of your child's last well visit. Documentation will be required at a later date. *

YYYY

As part of the registration process, we will need your child's birth certificate. *

I have my child's birth certificate.

I don't have my child's birth certificate. (You will need to get this before enrollment is complete)

As part of the registration process, we will need your child's social security card. *

I have my child's social security card.

I don't have my child's social security card. (You will need to get this before enrollment is complete)

A copy of your responses will be emailed to the address you provided.

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