2020-2021 Preschool Application
This program provides access and funding to a quality preschool program. This program does not cover charges for any additional services, such as daycare services outside of preschool times. Please complete this application if you would like your child to be enrolled and to participate in preschool. You will be notified of your child's participation and Preschool location when final placement decisions have been made.

NEW THIS YEAR: Preschool will be held on Mondays, Tuesdays, Thursdays and Fridays. There will be NO preschool on Wednesdays.

CHILD MUST BE 4 YEARS OLD ON OR BEFORE SEPTEMBER 15, 2020 TO QUALIFY.
Email address *
Name of Person Submitting Application *
Your answer
Child's Full Name (First, Middle, Last) *
Your answer
Child's Date of Birth *
MM
/
DD
/
YYYY
Gender *
Ethnicity *
Race (choose all that apply) *
Required
Mother's Name *
Required
Mother's Street Address *
Required
Mother's City, State and Zip *
Required
Mother's Email Address *
Required
Mother's Home Phone *
Required
Mother's Cell Phone *
Required
Mother's Work Phone
Your answer
Father's Name *
Required
Father's Street Address *
Required
Father's City, State and Zip *
Required
Father's Email Address *
Required
Father's Home Phone *
Required
Father's Cell Phone *
Required
Father's Work Phone
Your answer
Emergency Contact Information
Please list an emergency contact in case family contacts can't be reached.
Emergency Contact - Name *
Your answer
Emergency Contact - Relationship to Student *
Your answer
Emergency Contact - Number *
Your answer
Home Language Survey
What is your home language? *
Your answer
What language do family members use when speaking to the child in the home? *
What language does the child use when speaking to family members in the home? *
What language does the child use when speaking to other children in the classroom? *
What language does the child use when speaking to teachers? *
Preschool Site Choice
Please note, while it is our intent to place students in the preschool of choice, this application DOES NOT guarantee a spot at a preferred preschool due to transportation requests, classroom limits, etc.
Please indicate your preschool site choices. Preschool will be held Monday, Tuesday, Thursday, Friday. There will be NO preschool on Wednesdays. AM preschool times are 8-11 a.m. and PM preschool times are 12-3 p.m. *
Ekstrand AM
Grace Lutheran AM
St. Joseph AM
UCC AM
Ekstrand PM
Grace Lutheran PM
St. Joseph PM
UCC PM
1st Choice
2nd Choice
3rd Choice
4th Choice
5th Choice
6th Choice
7th Choice
8th Choice
Transportation
The Central DeWitt Community School District receives the right to make final preschool assignments based on the distance the child will need to be bused and availability of bus routes. Parents always have the option of providing their own transportation to and from their preschool of choice if there are openings.
AM Preschool in-town pick-up is at the nearest bus stop and drop-off is at the door.
PM Preschool in-town pick-up is at the door and drop-off is at the nearest bus stop.
Will your child need transportation to the preschool site? *
If yes, please list name, address and phone number for where your child will be located.
Your answer
Will your child need transportation from the preschool site? *
If yes, please list name, address and phone number for where your child should be dropped off below.
Additional Notes:
Your answer
A copy of your responses will be emailed to the address you provided.
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