Prairie Central Preschool Pre Registration
This is our pre registration form. Please fill out all the lines and we will send you a snap code to register.

If you need to provide proof of income, one of the following below is acceptable to document income:
- Pay stubs ( two most recent, consecutive)
- Proof of Women, Infants, and Children ( WIC) benefit
- Proof of Supplemental Nutrition Assistance Program (SNAP) benefit
- Proof of Temporary Assistance for Needy Families ( TANF) enrollment
- Proof of Supplemental Security Income (SSI) benefit
- Proof the family receives Child Care Assistance Program (CCAP)
- Tax return (most recent)
- Wages and tax statement ( most recent W-2)
- Verification letter from employer
- Proof that parent is enrolled in Medicaid
- Signed written statement from the family(provided form for families with no income)

Child's First Name *
Your answer
Child's Middle Name *
Your answer
Child's Last Name *
Your answer
Child's Birth Date *
Your answer
Gender *
Your answer
Parents/Guardian's Name *
Your answer
Phone Number *
Your answer
Address *
Your answer
Email Address *
Your answer
Student's School *
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