Branch ISD Common Preschool Application
Email address *
Student Information
Student First Name *
Your answer
Student Middle Name
Your answer
Student Last Name *
Your answer
Student Date of Birth *
MM
/
DD
/
YYYY
Student Gender *
Household Information
Street Address *
Your answer
City *
Your answer
Zip Code *
Your answer
County *
Parent/Guardian 1 Name *
Your answer
Parent/Guardian 1 Date of Birth *
MM
/
DD
/
YYYY
Parent/Guardian 1 Relationship to Student *
Your answer
Parent/Guardian 1 - Lives with student? *
Parent/Guardian 2 Name
Your answer
Parent/Guardian 2 Date of Birth
MM
/
DD
/
YYYY
Parent/Guardian 2 Relationship to Student
Your answer
Parent/Guardian 2 - Lives with student?
Home/Cell Phone *
Your answer
Work Phone
Your answer
Services Information
If bussing is available would you use the same address?
If you were able to choose a session which would you prefer? *
If you are NOT the biological or legal step-parent of the child do you have Court-appointed custody or legal guardianship?
Student’s Primary Language: *
Please list ALL languages spoken in household:
Your answer
Any special concerns?
Your answer
Were you referred to the preschool program? *
If yes, who were you referred by?
Description of Preschool Programs
Please check the box for any programs you are considering
Free for those who Qualify
Great Start Readiness: is the state funded preschool program for four year‐old children. Branch Intermediate School District provides this program for children and families who are residents in the school districts of Bronson, Coldwater, and Quincy community schools. School day sessions are offered. The curriculum for the program promotes cognitive, socio‐emotional and physical development. Health screenings, health and dental treatment, meals, transportation, and family engagement are all important aspects of the program. This program is free for eligible children and families. Teachers have a degree in Early Education. Please be prepared to spend approximately 15 minutes when application is turned in to meet with a staff member.
Head Start: is a federally funded program that serves three to five year‐old children. This program is free for eligible children and families who qualify. Half day and School day sessions are offered. The curriculum for the program promotes cognitive, socio‐emotional and physical development. Language and early literacy is an emphasis. Health screenings, health and dental treatment, meals, transportation, and family engagement are all important aspects of the program. Teachers have a degree in Early Education. Please be prepared to spend approximately 15 minutes when application is turned in to meet with a staff member.
Tuition Based Programs
Coldwater Schools Kinder Learning Academy: Coldwater Community Schools is pleased to offer this tuition based preschool to the community. The mission of this program is to provide a fun, activity‐based learning environment, while encouraging educationally‐based play, physical activity, and skills needed for kindergarten. Teachers in this program are trained in early education. The program is housed at Lincoln Center. Tuition Childcare is also available on site. Bussing is available for those students within Coldwater School district. We place 3 year old children in our morning session and 4 year olds in the afternoon.
Branch Area Careers Center Tot Spot Community Preschool: provides a developmentally appropriate learning environment that offers a variety of activities to foster physical, cognitive, emotional and social development. The certified staff uses a research‐based curriculum that focuses on an environmental approach to learning and prepares children for kindergarten. This program is a tuition based program with limited scholarships available.
The following documents are required as part of the application:
• Birth Certificate or proof of birth
• Current Immunization Record
• One of the following for Proof of Income (not needed if only interested in Tot Spot or Kinder Learning Academy)
1. Current W‐2s or current 1040 Tax forms
2. Proof of cash assistance or child care reimbursement from DHS
3. Copy of Social Security income (SSI or SSD)
4. Most recent check stub
5. Any other verified proof of income going back for the last 12 months
I do hereby give permission for Branch ISD Early Education Programs/ Coldwater Community Schools to exchange my child’s information with other public and private preschools for the purpose of enrollment. *
Required
Submit
Never submit passwords through Google Forms.
reCAPTCHA
This form was created inside of Branch ISD. Report Abuse - Terms of Service