Alcott Integrated Pre-School Program Lottery Application 2020-2021
This application form is to submit your child's name for the Alcott Elementary School Pre-School Lottery Program for the 2020-2021 school year. Completion of this form DOES NOT guarantee your child a spot in the Pre-School Program. A lottery selection will be completed in February/March 2020 and you will be notified by the Department of Student Services if your child is selected. Residency Requirements must be met in order to be enrolled in the Pre-School Program.

Please visit the Wolcott Public School's District website to view Residency Requirements. http://www.wolcottps.org.

If you have any questions, please contact Student Services at 203-879-8178.
Child's First Name *
Your answer
Child's Middle Name (If applicable)
Your answer
Child's Last Name *
Your answer
Child's Date of Birth *
MM
/
DD
/
YYYY
Child's Age *
Your answer
Gender *
Contact 1 Name (First and Last) *
Your answer
Contact 1 Phone Number *
Your answer
Is this a home, mobile or work number? *
Contact 1 Email Address *
Your answer
Contact 2 Name (First and Last) *
Your answer
Contact 2 Phone Number *
Your answer
Is this a home, mobile or work number? *
Does your child have any siblings that are currently attending Wolcott Public Schools? *
If yes, please list names of siblings.
Your answer
Has your child ever been in a pre-school program before? *
If yes, please list what program, dates of enrollment and location.
Your answer
Has your child ever received or is currently receiving services from Birth-to-Three? *
If yes, what services and which provider?
Your answer
Is your child receiving outside private services? *
If yes, what services and who is the provider?
Your answer
Do you have concerns regarding your child's development? *
If yes, please explain your concerns.
Your answer
What are your child's favorite activities? *
Your answer
What types of experiences would you like your child to enjoy in pre-school? *
Your answer
What would you like us to know about your child? *
Your answer
What are five adjectives that best describe your child? *
Your answer
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