2019-20 Application for Four Year Old Preschool Program

Eligible preschoolers must be four years old prior to September 15, 2019. Children who have turned 5 years old before September 15th, 2019 are not eligible. Exceptions are not allowed.

Preschool program locations for the 2019-20 school year will be determined in April when elementary enrollment numbers are more established.

Please complete the questions below and click the submit button.

STUDENT INFORMATION
Child's Legal Last Name *
Your answer
Child's Legal First Name *
Your answer
Child's Middle Name
Your answer
Child's Birth Date (must be born between 9/16/2014 and 9/15/2015 to be eligible) *
MM
/
DD
/
YYYY
Gender *
Ethnicity *
Required
Race (check all that apply) *
Required
Language Spoken *
Primary Phone (will be used as student's primary/home phone) *
( please use ###-###-#### format)
Your answer
Street Address *
Your answer
City *
Your answer
State *
Your answer
Zip Code *
Your answer
Does your child have siblings currently attending any school in the Iowa City Community School District? *
PARENT 1 INFORMATION
Parent/Guardian 1 Last Name *
Your answer
Parent/Guardian 1 First Name *
Your answer
Parent/Guardian 1 relationship to student (mother, father, grandparent, step-parent, guardian, etc.) *
Your answer
Parent/Guardian 1 Primary Phone *
Your answer
Parent/Guardian 1 Email Address - Confirmation letters will be emailed to this address. If you do not have a valid email address, please enter blank@example.com and paper copies of confirmations will be mailed. *
Your answer
PARENT/GUARDIAN 2 INFORMATION
Parent/Guardian 2 Last Name
Your answer
Parent/Guardian 2 First Name
Your answer
Parent/Guardian 2 relationship to student
Your answer
Parent/Guardian 2 Primary Phone
Your answer
Parent/Guardian 2 Email Address
Your answer
Due to the State Preschool Grant, we request the following information:
Please check any service(s) that you are currently receiving:
Preschool Selection - Preschool program locations for the 2019-20 school year will be determined in April when elementary enrollment numbers are more established.
Please select a different Elementary building for each preference below.
Preschool Building Preference #1 *
Preschool Building Preference #2 *
Preschool Building Preference #3 *
Home School Attendance Area - Based on your current address. *
AM/PM Session Preference - (times are subject to change) *
Required
Preference Priority -
For questions or if you wish to share additional information regarding your child's preschool application, please email the Preschool Program Secretary at kimm.randi@iowacityschools.org.
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