~WAITING LIST~  Preschool Waiting List Application for 2022-23 School Year
***This waiting list application does not guarantee your child's admission. Please DO NOT fill out the "CCSD online new student registration form" on the district website until you have been notified that your child has been accepted; only complete this waiting list application. If/when a spot becomes available, you will be notified.***

~Community preschools are located at Millville, Nibley, Greenville, Summit and Lewiston Elementary Schools and Mountain Crest and Sky View High Schools.
~Available to four-year-old children who turn four before September 1st, 2022 and live within Cache County School District boundaries.
~AM and PM sessions are available; however, exact start and end times will not be determined until August (typical hours are 9:05 am - 11:35 am and 1:05 pm - 3:35pm).
~Priority is given to students who qualify for free or reduced lunch and meet certain risk factors.
~Preschool tuition is $75.00 per month for two days per week or $125.00 per month for four days per week.
~Based on household size and gross annual or monthly income, we may be able to provide assistance with tuition.
~Transportation is not provided.
~If you have further questions, contact Fran Schumann at fran.schumann@ccsdut.org or Stacy Larsen at stacy.larsen@ccsdut.org.

Sign in to Google to save your progress. Learn more
Email *
Child's First Name *
Child's Last Name *
Child's Date of Birth *
MM
/
DD
/
YYYY
Parent/Guardian First Name(s) *
Parent/Guardian Last Name(s) *
Mailing Street Address *
City *
State *
Zip Code *
Phone Number (including area code) *
First School Choice *
Second School Choice *
Class Time Preference (start and end times will be determined in August) *
Number of Days Preferred *
Read the list below and select the statement that applies. *
 a) child was born to a teenage mother, b) child has been exposed to physical abuse or domestic violence, c) child has been exposed to substance abuse (drugs or alcohol), d) child has been exposed to stressful life events (death of a parent, chronic illness of parent or sibling, mental health issues),  e) child's parent(s) is or recently has been incarcerated, f) child lives in a neighborhood with high violence/crime, g) child has one or both parents with a low reading ability, h) child's family has moved one or more times in the last year, i) child is now or has recently been in foster care, j) child lives in a home with multiple families in the same household
Does your household qualify for free or reduced lunch? *
If you answered "I don't know" to the question above, please provide the number of people in your household and your gross monthly or annual income (specify monthly or annual),  ie: 4 people, $30,000 annually.
Is your child currently attending a preschool in one of our schools or receiving speech services in Cache District (IEP)? *
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
PrivacyTerms
This form was created inside of Cache County School District. Report Abuse
Google Forms