Daybreak Star Preschool Waitlist (SY20-21)
Please complete this form to be placed on our waitlist for the upcoming school year beginning September 2020.
Child (1) Full Name *
Your answer
Child (1) Birthdate *
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Child (2) Full Name (if applicable)
Your answer
Child (2) Birthdate (if applicable)
MM
/
DD
/
YYYY
Primary Parent's Full Name *
Your answer
Secondary Parent's Full Name (if applicable)
Your answer
Phone Number *
Your answer
Email Address
Your answer
Home Address
Your answer
If no address, where are you currently staying? Provide details if you are home/houseless, in-transition or non-secured housing (shelter/motel/etc).
Your answer
What is your child's identified race and ethnicity (select all that apply) *
Required
Please include details about selections above. (i.e., Tribal affiliations/ancestry; country of heritage) *
Your answer
Tell us about your child. What are some of your child(ren)'s interests?
Your answer
Why did you select Daybreak Star Preschool and what is your hope for your child(ren) through their educational experience here?
Your answer
Does your child(ren) have any particular needs, special learning accommodations, religious/spiritual requirements that we should be notified of?
Your answer
Does your child(ren) have any allergies or medical conditions that our teaching staff need to be notified of?
Your answer
How did you hear about our program? (i.e., Ina Maka Family Program, Family/Friends, Community Event, Other)
Your answer
Is there anything else you would like us to know about your child(ren) or your family?
Your answer
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