PCSD First-Step Peer Model Application 

We are excited that you are interested in your child’s participation in Parma City School District’s First Step Preschool program. In order to provide role models in all areas of development for our students, we include preschool aged Peer Models (children without disabilities) into the classroom. Please complete this application to tell us about your child. 

Upon receipt of this completed application, we will contact you with a screening date (fall or spring) and detailed instructions for coming into the screening. At the screening date, your child will meet the First Step staff and participate in a mock “preschool day.” Your child will separate from you. This is a time for parents to ask questions and meet with the Preschool Principal. 

Requirements for students to attend PCSD First Step Preschool as a Peer Model: 

1. Must be a resident of Parma, Parma Heights, or Seven Hills

2. Strong communication and social skills are preferred (but not required)

3. Must be completely toilet-trained 

4. Must pay tuition ($600 for the entire year; can be paid in quarterly installments and are subject to change; and $20 one time payment for school fees

5. Must have own transportation

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Email address *
Parent/Guardian Phone Number *
Child's Name *
Parent/Legal Guardian Name *
Home Address, City, Zip Code *
Child's Date of Birth and Current Age: *
Sex Assigned at Birth: *
Primary language spoken at home *
Who lives at home with the child?  *
Describe (if applicable) your child's relationship with his/her siblings *
Has your child ever received any Early Intervention Services? (Help Me Grow, Speech Therapy, etc.) *
Has your child ever received any evaluations or services from First-Step? *
Has your child attended any other preschool(s)? *
Please list any activities your child has participated in outside of the home (preschool sports, story time, play groups, library activities, nature center, camps, etc.) *
Please share why you feel that PCSD First-Step Preschool would be a good fit for your child: *
Please indicate whether you would prefer morning or afternoon Preschool (Note: we cannot guarantee your first choice, but we will try our best) *
Parent/Legal Guardian Signature (your typed name will count as your signature)  *
Permission for Review: In giving my permission by typing my name below, I understand that any or all of the following may occur: 

1. Review of relevant records (releases of information will be included)  

2. Interview with caregiver or myself 

3. Observation(s) of my child 

4. Assessment (e.g. curriculum-based, screening, and other appropriate measures to determine interventions) and/or 

I further understand and agree that the information collected by the school district will then be reviewed and the team will develop an intervention plan and designate the resources needed to implement these interventions

 *
Payment Contract for Peer Model Program First-Step Preschool

1. Payment: 

4 payments of $150* each. Payment schedule will be supplied. Payments must be kept current, or your child will be withdrawn.

TOTAL AMOUNT FOR THE YEAR = $600* 

Please place payment in your child’s backpack, in an envelope marked “OFFICE” with your child’s name and teacher’s name written on it. 

Only cash, check or money orders are accepted. 

MAKE CHECKS PAYABLE TO: PARMA CITY SCHOOL DISTRICT

2. My child will be automatically withdrawn from the program if payment is not made on time. The teacher will be notified not to accept the student into class if payment has not been received. 

3. If my payment is returned for insufficient funds, I will be notified and expected to make payment in the form of cash or money order. 

4. I will accept the responsibility of paying a supply fee of $20* in addition to tuition. The supply fee will be used to purchase items such as paint, paper, sand, play dough and other consumable items. The supply fee and the first $150 payment must be paid within the first week of attendance.

*Fees and tuition costs are always subject to change as determined by the Board of Education 


By typing my name below, I agree to the Payment Contract of the PCSD Peer Model Preschool *
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