Early Learning Preschool Interest Form
Thank you for your interest in an Early Learning Preschool program.  NEWESD 101 partners with 14 school districts and 3 licensed child care centers to provide Early Learning Preschool programs throughout northeast Washington. 
 
2023-2024 school year: Children must be 3 years old must have been born between 9/1/2019 and 8/31/2020; 4 years old must have been born between 9/1/2018 and 8/31/2019.
2024-2025 school year: Children must be 3 years old must have been born between 9/1/2020 and 8/31/2021; 4 years old must have been born between 9/1/2019 and 8/31/2020.
Applications for the 2024-2025 school year will be sent out in April, 2024. 

Please complete the interest form below to help us determine eligibility and best placement for your child. Completing this form expresses your interest in an early learning preschool program and does not guarantee enrollment. A staff member will reach out to you regarding our services and next steps.

NEWESD 101 respects your right to privacy. Information obtained is for the purpose of identifying which programs you may be eligible for and will not be shared with third parties.
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3. Site or District of Interest: *
1. Child's Full Name: *
2. Child's Date of Birth* (MM/DD/YYYY):  *
MM
/
DD
/
YYYY
Is this child a member of a tribal nation?  *
Language (select one): *
4. Parent/Guardian First and Last Name: *
5. Physical Street Address and City, State, Zip Code (including apartment number) *
Contact Phone Number *
Contact Email *
What is the best way to contact you?  *
Child lives with: *
Family size in household (total number of adults and children supported by family income) *
Household annual income (choose a range) *
Does your family qualify for food assistance - Basic Food benefits, SNAP, and/or Free or Reduced price meals program?  *
Is child currently enrolled in a preschool or early learning program, such as Head Start, Early Head Start, ECEAP, or Early ECEAP? *
*If yes, what is the name of the early learning or preschool program your child is enrolled in currently?
Does your child have: *
Required
Other considerations for enrollment (check all that apply) *
Required
Thank you! 
Thank you for taking the time to complete this interest form. 
One of our program staff will contact you with next steps as soon as possible. 
If you might qualify for Early Childhood Education and Assistance Program (ECEAP), you will be emailed a DocuSign Applications for the current school year to complete for eligibility and enrollment. Be sure to check your spam/junk folders within a week after submitting this form in case it is in there. 
2024-2025 school year ECEAP applications are not available until sometime in April, 2024. 
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