Preschool Application for Attendance
2020-2021 School Year
Email address *
In which district are you applying for preschool? *
Child's First & Last Name *
Your answer
Child's Date of Birth *
MM
/
DD
/
YYYY
Child's Gender *
Child lives with: *
Parents' Marital Status *
Mother's Name
Your answer
Mother's Date of Birth
MM
/
DD
/
YYYY
Mother's Highest Education Level
Father's Name
Your answer
Father's Date of Birth
Your answer
Father's Highest Education Level
Child's Address *
Your answer
Mailing Address *
Your answer
Best Phone Number *
Your answer
Additional Phone Number
Your answer
Is your child receiving any special services (i.e. speech therapy, special education)? *
Does your child have an IEP (Individualized Education Program)? *
What language is spoken in your home? *
Was either parent under the age of 20 when the child was born? *
If your child has a case number for Food Stamps, TAF, FDPIR or FAP, please list here.
Your answer
How many people live in your household? *
Your answer
Does your family exceed the annual income guidelines listed below for the number of people in your household?
If not, there is some income information required that does not fit well on this format. A form may be mailed to your mailing address listed above. Please return it to the school ASAP. Thank you!
Does another child in your household qualify for free or reduced lunches in the district?
Thank you! If you have any questions, please feel free to contact Janine Henry, Preschool Coordinator, at jhenry@three-lakes.org
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