J. Stephens International Academy Pre-K Program Application
Pre-Kindergarten (Students must be 4-years-of-age as of September 1st, 2018)
Please write the full name of your child *
Your answer
Indicate which session(s) you are enrolling for:
Child's Current Age *
Your answer
Child's Birthdate *
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DD
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YYYY
Name of person filling out application *
Your answer
Applicant's relationship to Child *
Child's Home Address *
Your answer
Phone Number (Area Code first) *
Your answer
E-mail address (optional)
Your answer
Has the child attended any prior daycare or pre-school? *
If so, where and for how long did the child attend? (If Child did not attend, write NA)
Your answer
What are some of your child's strengths?
Your answer
What are some goals or areas of improvement that you would like us to focus on to best serve your child's growth this year?
Your answer
Is there anything else you would like for us to consider in your child's application to our program?
Your answer
Does your child have siblings that currently attend or are planning to attend JSIA for the 2018-2019 school year?
If you answered "Yes" to siblings, please list names of siblings below. If answer is "no" then please leave blank or write N/A. If listed "maybe" or "other" please explain below.
Your answer
Does your child currently have an IEP?
If your child currently has an IEP you must also contact a program placement specialist through the District Student Assignment office. Students with IEPs are given priority to the most specialized programs designed to support their learning goals. Please notify the placement specialist that you are interested in the Pre-K program at JSIA.
Are you a District Employee?
If "yes," please list your working location and position. If not District employee, leave blank or NA. If you selected "Other", please explain below.
Your answer
Thank you for choosing James Stephens and for taking the time to answer all the questions on this application. If eligible, your child will be placed on our waiting list.
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