Application for Early Learning
2020-2021 School Year (Special Education - 3 to 5 years of age)
Online applications should be completed by a parent or legal guardian.
Early learning services are currently provided at five (5) locations. Placements are determined using USD 383 zoning boundaries as a guide, not parent preference.
Child's first name
As printed on birth certificate. Please do not use nick-names.
Child's last name
As printed on birth certificate.
Child's date of birth
American Indian or Alaska Native
Black or African American
Native Hawaiian / Other Pacific Islander
Multi-racial / Biracial
Hispanic or Latino?
What language(s) does your child speak fluently?
Child's insurance status
No insurance coverage
KanCare (Medicaid / State Med. Insurance)
Private / Other
Military Insurance (Tri-care)
Child's home address
Include Street Address, City, State, Zip Code, and County
Mailing address, if different
Include PO Box, City, State, Zip Code
Child has an I.E.P.
Individualized Education Plan
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