Open Spots for Pre-K- Application for August 2020
Please answer the questions below to apply for the Pre-k Program. You must also provide a copy of your child's official birth certificate, a copy of proof that your child is a Monroe County resident, and a copy of your household income. Once you have filled out this application, you may bring the documents above to the school you are applying for or to the central office (205 Oak Grove Rd. Madisonville).
Please check the school that your child is applying (this is your 1st choice). *
If your child does not get into the program above, do you have a second choice? *
I am interested in the Blended Pre-K Program offered at MPS? (Special needs students and typical students working cooperatively in the same classroom) *
Child's Name (first, middle, last) as it appears on the birth certificate. *
Child's Birthday (example 02/14/2015) *
Child's physical address (street address, city) *
Child's Race *
Child's Ethnicity *
Primary Language Spoken *
Medical (Please list any medical issues or special needs your child has). *
Medical (Does your child see a doctor for the medical issues that you listed above?) *
Is your child fully potty trained. (no pull-ups) *
Please list your monthly household income below. (You will still have to provide a copy of your proof of income.) *
How many people are living in your household? *
List the names of every adult living in your household. *
List the names of every child living in your household. *
Does the child have a parent who is deceased as a result of serving in the U.S. armed forces or who has been reported as a prisoner of war oar missing in actions? *
Bus transportation is not provided for Voluntary pre-k students or for typical peers in the Blended Program. I understand that I will have to provide transportation for my Voluntary pre-k child or for my child if he/she is a typical peer in the Blended Program. *
Who has legal custody of the child? *
Mother's Name (first, last) *
Does the child live with the mother? *
Mother's Address (street address, city, state) *
Mother's Phone Numbers (home, work, cell) *
Mother's email address: *
Father's Name (first, last) *
Does the child live with the father? *
Father's Address (street address, city, state) *
Father's Phone Numbers (home, work, cell) *
Father's email address: *
Other Guardian's Name (first, last) *Type "none" if your child does not have another guardian. *
Other Guardian's physical address *Type "none" if your child does not have another guardian. *
Other Guardian's phone numbers (home, cell, work) *Type "none" if your child does not have another guardian. *
Other Guardian's email address:
Does the child live with the Guardian listed above? *
I will be able to bring a copy of my child's birth certificate, a copy of proof of residency and income on May 4 or May 11 to one of the following locations: Vonore Elementary, Sequoyah High School, Madisonville Primary, or Tellico Plains Elementary. *
Please type in the name of the person completing this form (first, last) and list your relationship to the child. *
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