Family Child Education Wait List
Please complete the following survey to add your child to the wait list for our preschool and extended day programs. When a space becomes available one of our staff will contact you to enroll your child.
Email address *
Child name/ Nombre del niño/a *
Child's birth date/ Fecha de nacimiento *
MM
/
DD
/
YYYY
Do you have more than one child you would like to enroll? Please add additional children's names and birth dates.
Parent Name/Nombre del padre *
Address/Dirección *
Phone number (best number to reach you) Numero de teléfono (número donde encontrarlo) *
How did you hear about us? ¿Como supo de nosotros? *
Required
Preferred school location/Escuela de preferencia. *
What schedule do you need (select all that apply)? ¿Cual horario necesita? (Seleccione el que necesite) *
Required
What days of service do you need? ¿ Cuales días necesita servicio? *
Required
Is you child potty trained/¿Su hijo va solo al baño? *
State Income Qualifying Guidelines
If you believe your income falls within the state guidelines. Please answer the following questions.

Family Size & Gross Monthly Income
1-2 $5,343
3 $5,802
4 $6,719
5 $7,794
6 $8,869
7 $9,070
8 $9,272
9 $9,473
10 $9,675
11 $9,876
12 $10,078
Family monthly gross income? (Include all wage earners in the family) ¿Cual es el Ingreso monetario familiar al mes? (incluir todos los ingresos de la familia) *
Number of people in your family? ¿Cuantas personas hay en la familia? *
Parent 1: Are you currently working and/or attending college courses? Padre 1: ¿ Esta usted actualmente trabajando o atendiendo cursos escolares? *
Parent 2: Are you currently working and/or attending college courses? Padre 1: ¿Esta usted actualmente trabajando o atendiendo cursos escolares? *
If you are attending college courses what is your schedule? ¿Està usted atendiendo cursos escolares?
A copy of your responses will be emailed to the address you provided.
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