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4-year-old Tuition Preschool (full day)
Our tuition preschool program has a limited number of spots available. This application is not considered complete until $25 non-refundable registration fee is received, all documentation is turned in, application is signed and you receive a welcome letter from Imlay City Preschool.
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Email
*
Your email
If this classroom is full,
*
Add my child to the waitlist.
I would be interested in 1/2 day Tuition Preschool.
I would be interested in learning more about GSRP. (Full Day State funded Preschool)
Please contact me.
Other:
Child's Full Name
*
Your answer
Gender
*
Male
Female
Date of Birth
*
MM
/
DD
/
YYYY
Child's Birthplace
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City, State, Country
Your answer
Child's Home Address
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Number & Road
Your answer
City
*
Your answer
Zip Code
*
Your answer
County of Residence
*
Your answer
Home School District
*
Your answer
Primary Phone
*
Your answer
Secondary Phone
*
Your answer
Birth Father's Name
*
First & Last
Your answer
Birth Mother's Name
*
First & Last
Your answer
Birth Parents are:
*
Please check all that apply.
Together
Not Together
Married
Separated
Divorced
Other:
Required
Child lives with:
*
Birth Father and Birth Mother
Birth Father
Birth Mother
Step Parent
Grand Parent(s)
Foster Parents
Other:
Required
Is your family living in any of the following situations?
*
Staying in a shelter, temporary trailer, or waiting for foster care placement
Doubled-up -- sharing the housing with others/relatives due to loss of housing, economic hardship or similar reason
Living in a car, park, campground, public space, RV, substandard housing, or similar
Living in a motel or hotel due to loss of housing, economic hardship or similar reason
In an emergency or transitional shelter
Moving from place to place
Living with an adult that is not a parent or legal guardian
None of the above
Race
*
American Indian/Alaska
Asian/Asian American
Black/African American
Caucasian/White
Hawaiian/Pacific Islander
Other:
Required
Hispanic or Latino
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Yes
No
Primary Language
*
English
Spanish
Other:
Does your family migrate?
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Yes
No
If yes, approximate dates of migration?
Your answer
Parent/Guardian Information
Father/Legal Guardian Name
*
First & Last
Your answer
Father/Legal Guardian Employer
*
If not applicable, please write none
Your answer
Father/Legal Guardian Occupation
*
If not applicable, please write none
Your answer
Father/Legal Guardian Employer Phone
*
If not applicable, please write none.
Your answer
Mother/Legal Guardian Name
*
First & Last
Your answer
Mother/Legal Guardian Employer
*
If not applicable, please write none
Your answer
Mother/Legal Guardian Occupation
*
If not applicable, please write none
Your answer
Mother/Legal Guardian Employer Phone
*
In not applicable, please write none.
Your answer
Siblings
Sibling#1 Name & Date of Birth
*
First, last & date of birth (If not applicable, please write none)
Your answer
Sibling#2 Name & Date of Birth
*
First, last & date of birth (If not applicable, please write none)
Your answer
Sibling#3 Name & Date of Birth
First, last & date of birth
Your answer
Sibling#4 Name & Date of Birth
First, last & date of birth
Your answer
Sibling#5 Name & Date of Birth
First, last & date of birth
Your answer
Sibling#6 Name & Date of Birth
First, last & date of birth
Your answer
Active US Military
*
Yes
No
US Military Veteran
*
Yes
No
Comments/Additional Information
Your answer
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