School Readiness Application
Through a School Readiness grant funded by the Connecticut Office of Early Childhood, there are a number of spaces available in high-quality preschool programs at a reduced cost.
For the 2021-2022 school year, the Colchester School Readiness Program is actively seeking:
· Children who are not enrolled in a preschool program;
· Children who live in Colchester;
· Families who want a 5 day a week program;
· Families who may find it difficult to pay for preschool
* Required
Email address
*
Your email
Your Child's Street Address. Colchester residency will be verified before placement.
*
Your answer
Child's First Name
*
Your answer
Child's Middle Name
Your answer
Child's Last Name
*
Your answer
Child's Date of Birth
*
MM
/
DD
/
YYYY
Name of Parent to Contact
*
Your answer
Phone Number of Parent to Contact
*
Your answer
What option(s) below are you interested in?
*
CASTLE -School Day
Colchester Early Childhood Program -Part Day
Required
Primary Language in Home
*
English is primary language
Some English is spoken
No English is spoken
Gross Total Income of your Household from 2020 tax return. Income will be verified before the placement of a child into a program. Include Wages, SSI, Social Security, Rental Income, Worker’s Compensation, Unemployment, Foster Care Subsidy, Alimony, Pensions, Veterans Benefits, Cash Assistance, Dividends/Interest (if over $10/month). Please answer in $.
*
Your answer
Is your current income about the same as your tax return?
*
Yes
No, my income is higher.
No, my income is lower.
Number of Parent(s)/Parent's spouse in household
*
1
2
Number of Minor Children in Household
*
Your answer
About your Child
*
Yes
No
Receives Birth to Three or Other Special Education Services
Has attended a program before
Is a foster child
Yes
No
Receives Birth to Three or Other Special Education Services
Has attended a program before
Is a foster child
What stressors apply to your family?
Disabled or chronically ill parent
Sibling with a significant diagnosed disability
Incarcerated parent
Deployed military parent
Domestic violence concern
Mental health concerns
Substance abuse
Current DCF involvment
Homeless or insecure housing situation
Grandparent/Relative as Guardian
Multiple Children 3- 5 years old
Parent deceased
Parent does not have high school diploma or GED
Any additional comments or concerns about your child or your family situation:
Your answer
I attest that the information given is true and accurate to the best of my knowledge. Type your name in the box as your electronic signature.
*
Your answer
A copy of your responses will be emailed to the address you provided.
Submit
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