Early Childhood Screening Appointment Request
Free screening of children who will be at least age three (3) on or before September 1, 2019 will take place at Elizabeth Meyer School on Wednesday, May 15 and Thursday, May 16, 2019.

Screening is required for any student being considered for discounted tuition rates.

Child must be a resident of Skokie School District 73½ to qualify for this screening.

PLEASE NOTE: Discounted preschool tuition spots are LIMITED. Not all the children who are screened will be offered discounted tuition rates. After the screening, you will be notified about your child's eligibility.

CHILD'S INFORMATION
Please complete all the questions about your child.
Child's Last Name *
Your answer
Child's First Name *
Your answer
Gender *
Date of Birth *
MM
/
DD
/
YYYY
HOME INFORMATION
Residency is defined as that place where parent/legal guardians eat, sleep, and store their belongings; furthermore, it is that place in which their child resides with them for four or more days per week. A student's residence is the same as the person who has legal custody of the student. (Board Policy 7.60)

To be considered for discounted tuition, student must:
1. Live in Skokie School District 73½
2. Be at least age three (3) by September 1
3. Participate in Developmental Screening

Address *
House number and street name
Your answer
City *
Your answer
PARENT/GUARDIAN INFORMATION
Parent Last Name *
Your answer
Parent First Name *
Your answer
Best Phone Number for Parent *
Your answer
Parent E-mail Address *
Your answer
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