NEW Preschool Student Registration Form

Welcome to Skokie School District 73.5!

This form is the first step in enrolling your child as a Preschool Student at Elizabeth Meyer School in Skokie School District 73.5 school. Please carefully read and answer all the questions.

After completing this form, the next step is to bring your child's original birth certificate (must be a government-issued document), parent/guardian driver's license (with current address), and proof of home ownership/lease.*

Additional information and documents will be required to complete registration.

Thank you!

*Not required for non-resident tuition-paying preschool students

STUDENT INFORMATION

Last

Last name

This is a required question

First

First name

This is a required question

Middle

Middle name

This is a required question

Gender

Boy or Girl?

Boy
Girl

This is a required question

DOB

Date of Birth

USA Born

Was this child born in the USA?

This is a required question

If Not USA

If NO, on what date did child arrive in the USA?

Birthplace

In what City & State (if born in USA) OR Country (if born outside USA) was this child born?

This is a required question

HOME INFORMATION

Residency is defined as that place where parent/legal guardians eat, sleep, and store their belongings; furthermore, it is that place in which their child resides with them for four or more days per week. A student's residence is the same as the person who has legal custody of the student. (Board Policy 7.60)

Address

House number and Street

This is a required question

City

This is a required question

State

This is a required question

ZIP

ZIP Code

This is a required question

Residence

Do you own, rent or share your home?

Own
Rent
Share

This is a required question

If SHARED

If SHARED, who owns or rents the home that you share?

This is a required question

Relationship

If SHARED, how is the owner/renter related to this child?

Grandparent
Aunt/Uncle
Friend
Other:

This is a required question

Previous Address

If you moved to Skokie School District 73.5 less than 1 year ago, what was your address?

This is a required question

PARENT / GUARDIAN #1 INFORMATION

Please provide information about the person who is the primary caregiver for this child. This is the first person we would contact if the child is absent from school, or must be sent home due to illness.

Last PG1

Last name of Parent/Guardian #1

This is a required question

First PG1

First name of Parent/Guardian #1

This is a required question

Email PG1

Email address for Parent/Guardian #1

Invalid email address format

This is a required question

Relationship PG1

Relationship of Parent/Guardian #1 to this child

Father
Mother
Guardian
Other:

This is a required question

Address PG1

House number and Street, City, State, ZIP

Same as student
Other:

This is a required question

Phone PG1

Preferred phone number

Please enter phone number in this format: 123.456.7890

This is a required question

Phone Type PG1

Preferred phone type

Cell
Land
Work

This is a required question

Alternate Phone PG1

Alternate phone number

Please enter phone number in this format: 123.456.7890

This is a required question

Alternate Phone Type PG1

Alternate phone type

Cell
Land
Work
No alternate phone

This is a required question

PARENT / GUARDIAN #2 INFORMATION

If Mother was listed as Parent/Guardian #1, Father should be listed here.

Last PG2

Last name of Parent/Guardian #2

This is a required question

First PG2

First name of Parent/Guardian #2

This is a required question

Email PG2

Email address for Parent/Guardian #2

Invalid email address format

This is a required question

Relationship PG2

Relationship of Parent/Guardian #2 to this child

Father
Mother
Guardian
Other:

This is a required question

Address PG2

House number and Street, City, State, ZIP

Same as student
Other:

This is a required question

Phone PG2

Preferred phone number

Please enter phone number in this format: 123.456.7890

This is a required question

Phone Type PG2

Preferred phone type

Cell
Land
Work

This is a required question

Alternate Phone PG2

Alternate phone number

Please enter phone number in this format: 123.456.7890

This is a required question

Aternate Phone Type PG2

Alternate phone type

Cell
Land
Work
No alternate phone

This is a required question

ADDITIONAL HOME & PARENT INFORMATION

Custody

If parents DO NOT live in the same home, who has custody (the legal right to make education decisions)?

Parents live in the same home
Parent/Guardian #1
Parent/Guardian #2

This is a required question

Maiden

Mother's maiden name

This is a required question

SPECIAL SERVICES

Special Education

Was this child ever evaluated for Special Education?

This is a required question

If YES SpEd

If YES, was an education plan established?

This is a required question

If YES IEP

If an education plan was established, what services were recommended? (check all that apply)

Occupational Therapy
Physical Therapy
Speech/Language Services
An education plan was not established

This is a required question

Additional Information

Is there any other information the school should know about this child?

This is a required question

HOME LANGUAGE

Language

Is a language other than English spoken in your home?

This is a required question

If YES LANG

If YES, what is the home language?

This is a required question

PROGRAM SELECTION

Students who will be age four (4) on or before September 1 must attend classes every day. Students who will be at least age three (3) on or before September 1, but younger than age four (4) may select a Monday, Wednesday, Friday OR Tuesday, Thursday schedule. Three-year-olds may also select the full week option. All options are half-day, either morning or afternoon, in 2½-hour sessions. Morning sessions are 8:35-11:05 a.m Afternoon sessions are 12:15-2:45 p.m.

Preference

Five Mornings 8:35-11:05 a.m. -- Student may be either 3 or 4 by September 1
Five Afternoons 12:15-2:45 p.m. -- Student may be either 3 or 4 by September 1
Three Mornings Mon, Wed & Fri -- Student must be younger than age 4 by September 1
Three Afternoons Mon, Wed & Fri -- Student must be younger than age 4 by September 1
Two Mornings Tue & Thu -- Student must be younger than age 4 by September 1
Two Afternoons Tue & Thu -- Student must be younger than age 4 by September 1

Limited to 2 choices

This is a required question

FAMILY INFORMATION

Please tell us about any additional children in your family.

Only Child

Is the child named above your ONLY child?

This is a required question