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Someplace Else Learning Factory Free Preschool Eligibility Form
Please fill out each question below if you are interested in free preschool for your four year old in the 2020/2021 school year.
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* Indicates required question
Child's Date of Birth
*
MM
/
DD
/
YYYY
Child's name
*
Your answer
Child's Address
*
Your answer
Phone Number
*
Your answer
Alternate phone number
Your answer
email address
Your answer
Parent/Guardian Name
*
Your answer
Number of ALL (self, children, and other adults) household members for which you are financially responsible:
*
Your answer
Gross Income (How Much Money Did You Make in 2019) *
*
Your answer
I Will Prove My Income By: *
*
2019 W-2
recent pay stubs from employer
letter stating no income
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