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CCA 2019.2020 Four Year Old Preschool Application
PLEASE READ ALL THE INFORMATION AS OUR PRESCHOOL SERVICE DELIVERY IS CHANGING FOR THE 2019.2020 SCHOOL YEAR

Clear Creek Amana preschools has changed the service delivery model for preschool starting in the 2019.2020 school year. At all elementary sites, there will be an AM class and a PM class, Monday, Tuesday, Thursday and Friday (no Wednesdays). Students will be enrolled in one or the other class time. AM hours will be from 8:15 to 11:15 and PM class will be from 12:15 to 3:15. There will be NO CHARGE to qualifying students. To qualify for FREE preschool, a student must be the of age 4 on or before September 15th. There are no requirements for residency or income. Curriculum guidelines and assessment procedures will be the same for both AM and for PM classes.

Bussing: Students WILL be given the opportunity to be bussed to and from designated neighborhood stops, individual redidences and to the best of our ability, to currently licensed DHS daycares which reside in our district. CCA schools are not permitted per state requirements to bus outside of our boundaries. Bus stops and routes will be determined in the Spring of 2019 and updated as needed. Families will be notified of these stops.

School day/onsite daycare: Space permitting, an onsite daycare could be offered through a collaborative partner (Little Clippers) at selective sites. Amana and Clear Creek potentially might have room. There are no guarantees. Tiffin Elementary and North Bend Elementary are not likely to have the necessary space to partner for day care services.

Out of district families: In district families will have priority for enrollment. The district does anticipate being able to offer preschool to out of district families. Out of district families enrolled in preschool will still need to follow all open enrollment policies outlined by the School Board for school-aged years (Kindergarten). North Bend Elementary, Clear Creek and Tiffin Elementary are currently closed to open enrollment for kindergarten through 5th grade.

Will your child be 4 years old on or before September 15, 2019 *
Will your child be 5 years old on or before September 15, 2018? *
If YES, STOP. Your child is not eligible for the FREE portion of our preschool program and will be required to pay full tuition which will be dependent on the amount of state funds provided through the Voluntary Preschool grant. Principal permission will need to be given prior to students being able to enroll.
What is your child's birthdate? *
mm/dd/yyyy
MM
/
DD
/
YYYY
Your child's legal name *
Last Name, First Name, Middle Name
Your answer
Gender of your child *
Parent's/Guardian's Name(s) *
First Name, Last Name
Your answer
Parent's primary phone number *
000-000-0000
Your answer
Parent's secondary phone number
000-000-0000
Your answer
Physical street address *
House number and street name
Your answer
City, State, Zip *
Your answer
Mailing address if different from physical address
PO Box, City, State, Zip
Your answer
Do you reside in the Clear Creek Amana Community School District? *
Priority preschool placement will be given to children residing in the Clear Creek Amana Community School District. The district does anticipate being able to offer preschool to out of district families. Physical addresses are subject to verification.
Parent's email address *
Your answer
I am a Clear Creek Amana School District Employee *
Race/Ethnicity
This information is requested by the Federal Government in order to monitor compliance with civil rights law. You are not required to furnish this information, but are encouraged to do so. However, if you choose not to, under Federal regulations, the program's representative is required to note race/ethnicity on the basis of visual observation or surname. The Clear Creek Amana Community School District is an EEO/AA School District.
Race
Ethnicity
Preschool attendance center
In this portion you will be choosing your first and second choice for preschool attendance center.
1st choice attendance center *
Second choice for attendance center *
CCA schools will continue to collaborate with Little Clippers and Sprout Kids Academy (located in Tiffin, IA) to provide high-quality preschool programming. Both will offer the required minimum of 10 hours of free preschool a week and follow the same district and state guidelines as our school-based programs. *
Are you interested in learning more about our off site programming?
I understand there will be no charges associated with preschool if my child qualifies by age. *
I plan to utilize bussing for my child *
If yes, where would you need bussing to/from
I understand bussing will be provided to and from designated spots in neighborhoods, homes and to the best of the district’s ability, to offsite, licensed daycares within the boundaries of the district. *
I understand if my child is not enrolled in the time I prefer, I reserve the option to withdraw my child’s application. *
Extenuating circumstances in which you would prefer the AM or the PM class time. Given the complexities to bussing, scheduling and student needs, CCA reserves the right to staff students in either the AM or PM class times. There are no guarantees on the choice of class time.
Your answer
Name of person submitting this application *
Your answer
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