2018 Preschool Application

Enrolling for Fall 2018, child must be 3 yrs on or before September 1, 2018.

ex: 10/05/1980​​
Ex: 555-555-5555
Ex: 555-555-5555
Ex: 555-555-5555
Email required for Confirmation Information​​​​​

ex: 10/05/1980​​​

FAMILY INCOME (Select Source and enter total monthly amounts for both adults listed above)

Include: Employment, Child Support, Disability, Unemployment, TANF, Foster Care.​​​​​​​
Enter Total Gross Monthly Income​​​​​​

LIST ALL CHILDREN IN THE HOME (youngest first)

ex: 10/05/1980​​
ex: 10/05/1980​​​
ex: 10/05/1980​​​
ex: 10/05/1980​​​
Please select your first, second and third choices for your preschool location.​​​​​​​​​​​​​
Comments/Questions/Important Information​