26/27 Starflower Early Childhood - Application Questionnaire
Please note that the 2026/27 schedule is tentative and subject to change based on enrollment.

We know all families are beautifully different, and there aren’t any wrong or right answers to these questions. We provide this questionnaire simply to gauge the compatibility of potential students and their families with our program values and class composition before furthering the enrollment process.

If you have more than one child interested in enrolling, please fill out each section with the first child's name and answer for them followed by the second child's name and answer for them.

Even if your child has been in group with us before and we know them well, we like to use the information provided here to better inform some of our plans for the year. 
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Email *
Parent(s) Name(s) *
Primary contact number *
Address *
Child's Name *
Child's date of birth *
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Child's Gender *
Required
Children in Starflower Early Childhood must be able to use the toilet when the need arises. Can/does your child use the toilet independently? *
Required
Please elaborate if needed (does your child have regular accidents? Is your child sensitive to the toilet flushing? Anything notable pertaining to toileting.) *
Any dietary restrictions, food allergies, insect or environmental allergies? If yes, please list the restrictions in detail, severity of allergy (what level of exposure sensitivity to each allergen), as well as if they require an EpiPen. (If EpiPen is required, please include in your response that, if accepted, you give permission to facilitators to administer in case of emergency.) 
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Please give detailed information (name, contact number, secondary contact number if applicable) for emergency contact other than primary caregiver in the event that primary caregiver is unavailable. 
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*Please make your preferred schedule choice below. (we will do our best to acommodate first choice but may offer an alternate schedule based on enrollment) 

With monthly co-op involvement, the Starflower Program has a few options for attendance and prices as follows:

Two half days (9:30-12:30) - $3200
Two full days (9:30- 2:30) - $4600

(Gauging interest for future planning) Three half days (9:30-12:30) - $4800
 Three full days (9:30 - 2:30) - $6900

A deposit equal to 10% of your total payment is required to reserve your child’s space in the program upon acceptance.

Please let us know your desired payment plan (pay in full, 3 trimester payments, or monthly payments). We will be in contact with specific payment details upon your acceptance into the program.
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Required
*Starflower will have lunch from 12:00-12:30 each day.

Would you like to sign up for the New Earth Traditions Organic Lunch Program for 2026/27? The cost of the program is estimated to be $640/year per child in a two day enrollment and $960/year per child in three day enrollment. Lunch program enrollment can be paid in full or broken up with trimester or monthly payments. Exact amount will be determined in the very near future.)

Families may still choose to pack lunch at any time, but enrollment in the program guarantees your child a lunch on any day of attendance. If there are extra servings left over on any given day, children not enrolled in the program will have the option to buy a lunch at a daily rate OR additional portions can be purchased at a daily rate as "dinner take homes" by any enrolled family.

**Sample Menu: (this is an example of what one week might look like. Menus will vary week to week with recipes rotating in no more often than monthly in most cases. Seasonal fresh fruit and/or vegetables will always be served in addition to the main meal and dessert.)

Tuesday: Lentil Shepherd's Pie, Apple Crisp
Wednesday: Chicken & Veggie Soup with Sourdough Bread, Oatmeal Cookies
Thursday: Loaded Southwest Sweet Potato, Lemon Basil Sorbet
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Required
What curriculum(s), if any, do you plan to use at home? *
What is your most important goal for your child this school year?
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What is your most important social, emotional, or other personal development goal for your child this school year? *
In regards to hands-on caretaker involvement, would you say your child is: *
Has your child ever been a part of any sort of drop-off program? *
Describe your child's temperament in general and when in a social setting. (Would you describe them as shy or outspoken, etc.? Do they get along easily with other children? Are they able to take direction from another adult? Do they have a tendency toward rough physical play? Do they get easily overwhelmed around large groups? How are they with body boundaries? Etc.- please be as detailed as possible)
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What are your child’s biggest strengths? *
What are your child’s main challenges?
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Would you describe your child’s digital screen use (computers, tablets, phones, television) as generally:
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If any, does your child’s media intake (screens, books, audio/radio etc.) include depictions of violence, crude language, or other topics that could be deemed controversial or otherwise not "age appropriate"?
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If Yes, please elaborate:
Are you willing to participate in the co-op portion of this program up to one week per month?  *
Additional comments or questions?
I understand that my child(ren)'s space in Starflower Early Childhood is only secured once I receive an acceptance notification, forms are signed, and initial payment has been received.

We may reach out to schedule an in-person meeting before moving forward.

We are currently accepting waitlist applications to be decided upon as space allows. You will receive an email when enrollment opens. 
In the event there are no spaces available, or a child is not ready for the program or does not currently fit into our class balance, they will be placed on a waitlist for potential future enrollment.
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Required
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