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2019/2020 SPACE Preschool Interest Form
Complete one form for each child
Email address *
Please fill out this interest form to be put on the wait list for next year. We will contact you if a spot opens up.
Parent's Name *
Your answer
Mailing address *
Your answer
Phone number *
Your answer
Text OK? *
Child's Name *
Your answer
Child's age on Sept 1, 2019 *
If your child will turn 3 in September or October and you would like to enroll him/her in preschool, please make a note here including your child's birthdate.
Your answer
Check all classes that you are interested in? (check as many as apply) *
Please select (only one) class that is your FIRST choice. *
Are you interested in the 3rd day of preschool? The class will have a STEAM focus (Science, Technology, Engineering, Art, & Math) They will take place in the afternoon 12:20-3:30 either Tuesday or Wednesday. *
Are you currently enrolled in the SPACE program? (Remember you (the parent) are the student) *
If you answered "no" to the above question, have you been enrolled in the SPACE program in the past?
How many total semesters have you (the parent) attended the SPACE program (include 2018/2019 year)? (We have 2 semesters in 1 school year.) (Make sure to include the 2018/2019 school year.) *
Your answer
If there are any questions or comments you would like to include, please do that here. Thank you!!
Your answer
Please feel free to contact Stacy Bouchard at if you have any questions.
A copy of your responses will be emailed to the address you provided.
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