Water Valley ISD Pre-K Registration
Welcome to the Water Valley Independent School District!

In order to qualify for the PK program, you will need to complete this form and email the following documents to tracy.randolph@wvisd.net:

*Child's Birth Certificate
*Child's Social Security Number
*Proof of Residence
*Child's Immunization Records (current)
*Registering Person's Driver's Licence
*Applicable legal documentation, custody paperwork, etc...

Income Verification:
*Last two months of household's income (3 most recent pay stubs or Tax Form 1040)
*Supplemental Nutrition Assistance Program (SNAP) benefits letter
*Department of Defense Identification (If qualifying based on military)
*Letter documenting conservatorship by the DFPS (if qualifying based on foster placement)
*Star of Texas Award Certification

NEED ASSISTANCE?
For more information, please contact Mrs. Randolph at tracy.randolph@wvisd.net 
or call 325-484-2478 ext. 100

Once your application has been processed, you will be contacted by campus personnel. If your child qualifies, you will be provided an enrollment packet.

We look forward to meeting you and your little Wildcat this fall.

*Required
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Email *
Last name of Child *
First name of Child *
Middle name of child
Gender *
Are you Hispanic or Latino? *
Race *
Child's Date of Birth (Month, day, year) *
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YYYY
Age *
Parent Name *
Primary Language: Parent *
Primary Language: Child *
Mailing Address *
Child lives with: *
Mother's Name *
Mother's Date of Birth *
MM
/
DD
/
YYYY
Mother's Cell phone number *
Mother's email address *
Mother's High School Grade Completed:
Father's Name *
Father's Date of Birth *
MM
/
DD
/
YYYY
Father's Cell phone number *
Father's email address
Father's High School Grade Completed:
Do you receive any of the following? *
Required
List the Name, Age, Employer, Monthly Income, Source of Income for every person living in the home: *
Do you have: Dental Insurance *
Do you have: Vision Insurance *
What are your living arrangements? *
Required
Do you have reliable transportation? *
Will you need transportation for your child? (Please note in order for your four-year old to qualify for bus transportation, you must live outside the 2-mile radius from the school campus) *
Has your family moved any time during the last 3 years from one school district to another in Texas or to another state? *
If yes, were any of those moves made to find temporary or seasonal work in agriculture related jobs such as packing, processing, harvesting, cultivating of crops, food processing, dairy work, forestry and/or fishing? *
Has your child been diagnosed with a disability? *
If yes, what type of disability?
If yes, has your child received services for the disability?
Clear selection
If yes, where and what type of services were provided for your child?
Does anyone else living in the home have a disability?
Clear selection
Do you believe that your child has some type of disability? (Example: difficulty saying sounds of words; problems hearing; walking; learning; slow development of skills) *
If yes, please describe:
Does your child have any allergies (not seasonal)? *
If yes, please describe:
Is the student the child of an active duty member of the armed forces of the United States, including the state military forces or a reserved component of the armed forces, who is ordered to active duty by proper authority? *
Is the student the child of a member of the armed forces of the Unite States, including the state military forces or a reserved component of the armed forces, who is injured or killed while serving on active duty? *
Has the student EVER BEEN in the conservatorship of the Texas Department of Family & Protective Services (DFPS) (foster care) following an adversary hearing? *
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