Notice of Interest - Peer Model Student, BPS Integrated Early Childhood Program
*** MUST BE A RESIDENT OF THE TOWN OF BELCHERTOWN ***
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*** This form serves as notice of your interest in enrolling your child as a peer model student in our Integrated Early Childhood Program for the upcoming 2024-2025 school year. THIS FORM DOES NOT GUARANTEE A SPOT IN THE PROGRAM.  If the number of interested peer model candidates exceeds our allotted number of spaces, a lottery will be held. You will be notified if your child has been assigned a spot in early May 2024.***
Child's Name: *
Child's Date of Birth: *
(Child must be 3, born on or before 9/01/2021)
Is your child toilet trained? *
(Child must be fully toilet trained to attend program.)
Are you a resident of Belchertown, Massachusetts?
(Must be a resident of Belchertown, MA to be eligible for the program. You will be asked to provide documents to confirm residency.)
 *
Parent/Guardian Name: *
Parent/Guardian Phone Number: *
Parent/Guardian Email Address: *
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