Preschool Registration Form - 2024-2025 School Year - 4-Year-Old’s

Preschool Registration Form - 2024-2025 School Year - 4-Year-Old

*All classes are subject to change due to enrollment numbers.
(Child must have turned 4 on or before September 1 to be eligible for enrollment)
School calendars will be shared once placement letters are sent.

Monthly charge: 5 days a week tuition $235.00 3 days a week tuition: $157.00

Student's full name:

Person registering this child:

Name you want used in school on name tags, cubby, etc.

Birth Date:

Age:

Gender

Are Immunizations up-to-date?

Yes No

Preschool Screened?

Yes No

If yes, was re-screening recommended?

Yes No

Has received early intervention services or early childhood special education in the past?

Yes No

English Spoken Fluently?

Yes No

If no, which language?

Primary caregiver(s)

Mother Father Grandparent Guardian/Foster

Father's Name:

Address:

City/State/Zip

Primary Phone/Cell #:

Place of Employment:

Mother's Name:

Address (if different):

City/State/Zip:

Primary Phone/Cell #:

Place of Employment:

Email:

Please indicate your 1st choice for class options: 5 day am, 5 day pm, 3 day am, 3 day pm

Please indicate your 2nd choice for class options: for class options: 5 day am, 5 day pm, 3 day am, 3 day pm

Please indicate your 3rd choice for class options: for class options: 5 day am, 5 day pm, 3 day am, 3 day pm

Please indicate your 4th choice for class options: for class options: 5 day am, 5 day pm, 3 day am, 3 day pm

I intend to pay the $35 non refundable registration fee online or drop off a check or cash to the Bluff View main office?

Tuition payments are due on the first class day each month, September 2024-May 2025. $35.00 per child NON-Refundable REGISTRATION FEE due at this time (make checks payable to ISD #813) I would like to apply for an educational scholarship for my child. Scholarships are income-based. An "Application for Educational Benefits" along with supporting documents must be completed and submitted with this registration form. In addition, I authorize Lake City schools to share my information with Head Start if there is a possibility of income eligibility. Choose one of

Yes No

Send a copy of the completed form to this email address :