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Preschool Child Find Application
If you are interested in our Little Whippets Preschool, please complete the following initial application.
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* Indicates required question
District of Residence
*
Shelby City Schools
Other
Child's Last Name
*
Your answer
Child's First Name
*
Your answer
Child's Middle Name
*
Your answer
Child's Gender
*
Female
Male
Child's Date of Birth
*
MM
/
DD
/
YYYY
City of Birth
*
Your answer
Parent/Guardian's Name
*
Your answer
Street Address
*
Your answer
City
*
Your answer
State
*
Your answer
Zip Code
*
Your answer
Phone (Home)
Your answer
Phone (Cell)
*
Your answer
Phone (Work)
Your answer
Do you have any custody papers for this child?
*
Yes (will be asked to provide these if officially enrolled)
No
Siblings (Names and Date of Birth MM/DD/YYYY)
Your answer
Do you have any of the following developmental concerns?
*
Speech and Language
Behavior/Social
Fine Motor (Occupational Therapy)
Gross Motor (Physical Therapy)
Medical
Other
None
Required
Has your child ever received or been referred by a physician for developmental services?
*
Yes
No
Has you child ever attended another preschool or child care setting?
*
Yes
No
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