Fall 2024 St. Stanislaus Kostka Preschool Registration Form

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$75 Registration Fee will be added to your tuition payment account once your student is accepted.

Please note: All preschool offerings are dependent on enrollment. All applicants must be potty-trained and at least 3 years old as of September 1st.

For the 2024-2025 academic year, the 3 Year Old Preschool Program will ONLY run on Tuesdays and Thursdays. If you have a 3 year old, please select either 2 Half Days or 2 Full Days below. If you have a 4 year old, you may select any of the options below.

Email *

Date of Application *

YYYY

Kindly select the program you wish for your child: *

2 Half Days (Tues & Thurs 8:30-11am)

3 Half Days (Mon, Wed & Fri 8:30-11am) 4 Year Old Program Only

5 Half Days (Mon-Fri 8:30-11am) 4 Year Old Program Only

2 Full Days (Tues & Thurs 8:30am-3pm)

3 Full Days (Mon, Wed & Fri 8:30am-3pm) 4 Year Old Program Only

5 Full Days (Mon-Fri 8:30am-3pm) 4 Year Old Program Only

If there are specific days (outside of the options above) that you would like your 4 year old to attend, please specify here. (The 3 Year Old Program will ONLY run on Tuesdays and Thursdays.)

Student's First Name *

Student's Middle Name *

Student's Last Name *

Student's Date of Birth *

YYYY

Student's City of Birth *

Student's Gender *

Male

Female

Required

Home Address: Street Address *

Home Address: City *

Home Address: State *

Home Address: Zip Code *

Parent/Guardian's Name #1 *

Parent/Guardian #1 Occupation *

Parent/Guardian #1 Cell Phone *

Parent/Guardian #1 Email *

Parent/Guardian's Name #2 *

Parent/Guardian #2 Occupation *

Parent/Guardian #2 Cell Phone *

Parent/Guardian #2 Email *

Race/Ethnicity *

Child lives with: *

Religion *

Catholic

Non-Catholic

Baptized *

Yes

If applicable, which church was your child baptized in and on what date?

Parents are registered members of: (Name of Church & City/Town or N/A) *

My child is insured by: (Name of Insurance Provider or N/A) *

Early Childhood Intervention Services: *

Yes

Individual(s) responsible for payment of tuition: *

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

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