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FSSD Voluntary Pre-K Application 2023-2024 School Year
Please complete the application below to begin the qualification process for Voluntary Pre K in the Franklin Special School District for the 2023-2024 school year. Once the application is completed, more information will be mailed to your home address early in March. To be eligible:

• Children must have been born on or between August 16, 2018 and August 15, 2019
• Live in the Franklin Special School District

The Tennessee Department of Education Office of Early Learning requires school districts first serve students whose family meets specific income qualifications. Space permitting, students may be served who have disabilities, are identified as English Learners, are in state custody, or are identified as educationally at-risk for failure due to circumstances of abuse or neglect. Please contact of the Office of Student Support Services at (615) 591-2802 if you have additional questions.

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Date of Application *
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Student
Last Name *
First Name *
Middle Name *
Preferred Name
Birth Date *
Please enter Month, Day, and Year.
MM
/
DD
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YYYY
Gender *
Parent
Last Name *
First Name *
Address
Street Address *
City *
State *
Zip Code *
Phone *
Email
Family Information
Student Lives With: *
Check all that apply.
Required
Does the adult checked above have legal custody of the child? *
NOTE: Documentation of guardianship will be required if the child lives with an adult other than parents.
Please list any other adults (over 18) who live in the home.
Please list all children who live in the home and their ages.
What language is spoken in the home most of the time? *
What other languages are spoken in the home?
Primary language spoken by parents? *
Previous Education
Has the child previously been enrolled in a preschool program? *
If yes, please list the dates your child attended.
Type of preschool attended.
Has your child received services such as TEIS, Speech, OT, PT etc., or have a current IEP?
Clear selection
Transportation and MAC
Transportation is not provided for Voluntary Pre K. If selected, will you be able to bring your child to school and pick him/her up every day? *
Would you be interested in morning/afternoon care for a fee? *
Please ask about aftercare during your application appointment coming up in April. There will be limited aftercare seats available.
Student Health
Does your child have any food or seasonal allergies?
Please list.
Medical/health history of your child such as premature birth, serious illness, tubes in his/her ears, etc.
Medications your child takes regularly.
Please explain any area of concern you have about your child’s development.
Would you describe your child as
Check all that apply.
Community Pre-K Advisory Council
The information below will be treated as confidential and not shared with the school/teacher.  Although optional, this information will be used for determining eligibility based on the criteria established by the Community Pre-K Advisory Council.
Please check any of the following items that pertain to your child.
Submit Application
I certify that the information given is true to be the best of my knowledge and belief.  I agree to notify Franklin Special School District if there is any change in this information prior to the beginning of school.  I further understand that falsification of information or inaccurate information will result in the dismissal of my child from the FSSD Voluntary Pre-K program.
Parent Signature *
Please enter your name to agree to the above statement and submit the application.
Submit
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