Reverse Mainstream Program Application
Chesapeake Public Schools offers a Reverse Mainstream Program. This program allows three-year-old and four-year-old non-disabled children the opportunity to attend early childhood special education classrooms that are designed for children with developmental delays.  This program is five half-days a week.  

Applicants must be three-years-old or older on or before September 30, 2024.  Applicants turning five-years-old on or before September 30, 2024 are not eligible for this program.

Application does not guarantee acceptance; developmental screening will be administered to all applicants.
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Email *
Child's Name (Last Name,  First Name    Middle Initial) *
Child's Date of Birth *
Applicants must be 3 years-old or older on or before September 30, 2024.  Applicants turning 5 years-old on or before September 30, 2024 are not eligible for this program.
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Is your child: *
Child's Home Address:   *
This program is for children residing within the city of Chesapeake only.
Which school would you like your child to attend?  

Bus transportation will be provided by CPS within your child’s home school zone only. Parents are responsible for providing transportation outside of your child’s home school zone.
Mother / Guardian's Name *
Mother / Guardian's Home Address *
Required
Mother / Guardian's Phone Number
 *
Mother / Guardian's Email Address *
Father / Guardian's Name
Father / Guardian's Home Address
Father / Guardian's Phone
Father / Guardian's Email Address
Do either of the parents / guardians work for Chesapeake Public Schools? If yes, please list school/building under 'Other'.
Has your child previously attended or is your child currently attending a preschool or daycare facility?  If yes, please indicate which facility.  
 *
Please read the following:
I understand that completion of this application does not guarantee acceptance into the Reverse Mainstream Program.  I understand that my child will receive a developmental screening and the results will be shared with me, and if my non-disabled child is selected for the program I will complete Chesapeake Public Schools Enrollment. I further understand that acceptance is for one school year only, and my child may be removed from the program if discipline becomes a concern, or if my child has been found eligible for special education services.  I understand that I will be contacted to schedule a developmental screening.  Confidentiality requirements will be upheld.
 *
Please type your full name to indicate that you read and understand the above and to complete the application. 
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