NSCS Preschool Enrollment Form 2023-2024
If you prefer to fill out a paper form of this application and mail it to North Shore Community School, 5926 Ryan Rd, Duluth, MN  55804, please click HERE. Paper forms are also available in the NSCS office.

NSCS Preschool has a limited number of spaces available. As more applications may be received than the number of spaces available, you will be contacted by the Preschool coordinator when it is determined whether or not your preschooler has been accepted.

***A nonrefundable registration fee of $30 is required to hold your child's place in NSCS Preschool for the upcoming year. Please drop off the fee in the NSCS office or mail to:
North Shore Community School, Attn: Preschool Registration, 5926 Ryan Rd, Duluth, MN  55804

Applications and registration fees are due by March 1st, 2023.
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Email *
DAY SELECTION
NSCS offers half and full day options, and 2 or 4 day options for 4 or 5 year old preschoolers. Child must be 4 years old by 9/1/2019. We also offer a half day, one day option for 3 year old preschoolers. Child must be 3 by 9/1/2020.
Please select the preferred days:
If you are open to more than one option, you may check more than one box. 3 Year old option: Friday AM ONLY *
Required
Child's Last Name *
Child's First Name *
Child's Date of Birth: *
MM
/
DD
/
YYYY
Child's Street Address: *
Child's City *
Child's State: *
Child's Zip Code: *
This Child is under the custodial care of:
please select one. *
Four and five year old preschool students are eligible for busing during regular NSCS bus routes. Please indicate if you are interested in busing: *
PARENT/GUARDIAN INFORMATION
Please fill out all information for both parent/guardians. If child has only one parent/guardian, you may leave the information requested for the second parent/guardian blank. 
1. Parent/Guardian Name: *
1. Parent/Guardian Address:
Street Address, City, State  ZIP
 *
1. Parent/Guardian Primary Phone Number: *
1. Parent/Guardian Secondary Phone Number:
1. Parent/Guardian Email Address: *
2. Parent/Guardian Name:
2. Parent/Guardian Address:
Street Address, City, State  ZIP
2. Parent/Guardian Primary Phone Number:
2. Parent/Guardian Secondary Phone Number:
2. Parent/Guardian Email Address:
SIBLINGS:
Please list your preschooler's siblings, and indicate if any are currently attending NSCS
Please list your preschooler's siblings names:
Do any of your preschooler's siblings currently attend NSCS?
Clear selection
CONTACTS/EMERGENCY CONTACTS:
People who have permission to pick up your child and/or we should contact in an emergency if parent/guardian is unavailable:  Please list at least 2 contacts other than parents.
1. Contact Name: *
1. Contact Phone #: *
2. Contact Name: *
2. Contact Phone #: *
3. Contact Name:
3. Contact Phone #:
Child's Doctor/Clinic Name: *
Child's Doctor's Phone #: *
Child's Dentist: *
Child's Dentist's Phone #: *
Please list any allergies your child has:
Please list any medications your child is receiving:
Please list any of your child's health conditions the NSCS Preschool staff should be aware of:  (This will remain confidential)
Please tell us how you heard about our Preschool Program:
PUBLIC RELATIONS PERMISSION:
Occasionally students and/or parents are photographed or recorded on audio or video tape while they are engaged in  various educational activities. These pictures or tapes may be used in various ways: either to promote the program or  in some educationally related manner. In that such photographs or recording is voluntary, we seek your permission to use your family or child in our project. No child will be recorded without parental approval. No photograph will be  used as promotional material or in an educationally related project without parental approval.
Does NSCS Preschool have permission to photograph and/or electronically record your child for educationally related purposes in the Preschool Program, and use such photos or recordings for educational distribution? *
PARENT/GUARDIAN SIGNATURE
By checking the box below and submitting this form, you agree that the above information is accurate.
 *
Required
A copy of your responses will be emailed to the address you provided.
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