Peer Model Interest Form
Thank you for expressing your interest in the Peer Based Preschool Classroom Model. More information will follow upon the availability of placement for your child.
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Child's Name *
Sex
Birth date *
Must be at least 3 1/2 years old by September 30
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Parent's name(s) *
Address *
Home Phone #
Work/Cell Phone #
Email *
Is the elementary school your neighborhood school? *
Is the child a sibling of a current preschool education student? *
Does your child have any preschool experience or currently attending a preschool? *

Please indicate your first and second choices for class session.  This information will be taken into consideration along with your child’s age and ability levels.

First choice
Second choice
Not requested
AM session Monday - Friday (9:05 a.m. - 12:25 p.m.)
PM session Monday - Friday (12:30 p.m. - 3:50 p.m.)
Clear selection
Please indicate which days of the week your child would be able to attend. *
Required
FCPS does not provide bus transportation. Please confirm that you are able to drop off and pick up your child. *
Submit
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