Enrollment Application for Public Pre-Kindergarten

Applying for public Prekindergarten does not automatically guarantee enrollment into our program. We have a limited amount of spaces based on funding and restrictions. In order for your application to be considered, you must complete this application and attach ALL required documents.
Make sure you have all required documents ready and available before submitting this form. Applications without required documents will not be processed and may affect your child's placement into our program.
If you are unable to attach all required documentation, please bring physical copies of the documents to The Learning Bee to be considered.

Required Documents Include:
1. Two consecutive pay stubs within the last 6 months OR 2022 tax returns (1040) OR 2022 W2s OR Unemployment Verification
2. Child's Birth Certificate
3. Verification of address (current property tax bill or utility bill or current rental lease)

Student Information

Child’s Full Name:(Required)

First Last

Nickname:

Birthdate:(Required)

Child’s Gender:(Required)

Child’s Physical Address:(Required)

Street Address Address Line 2 City State ZIP Code

Family Information

Child lives with:(Required)

1. Parent/Guardian Name:(Required)

Relationship:(Required)

Home Phone:(Required)

Mobile Phone:(Required)

Email:(Required)

Address:(Required)

Street Address Address Line 2 City State ZIP Code

Employer:(Required)

Work Phone:

Employer Address:(Required)

Street Address Address Line 2 City State ZIP Code

2. Parent/Guardian Name:

Relationship:

Home Phone:

Mobile Phone:

Email:

Address:

Street Address Address Line 2 City State ZIP Code

Employer:

Work Phone:

Employer Address:

Street Address Address Line 2 City State ZIP Code

Parents are (check all that apply):(Required)

Living Together

Separated

Divorced

Widowed

Married

Unmarried

Will you need before and/or after care. Preschool is from 8:45-3:15 There is a charge for B/A care:(Required)

Before Care 7:30-8:45 am

After Care 3:15-5:15 pm

The Learning Bee seeks and admits students without regard to race, color, creed, sex, ethnic origin, disabilities and health care needs. The school does not discriminate in the administration of its policies and program.

Total household gross income- must be verified to qualify for placement. List all household members ( including yourself) even if they do not receive an income. Household income MUST be documented by submitting one of the following: 2 consecutive paystubs within the last six months; or 2022 tax return (1040); or 2022 W’2’s; or unemployment verification. Include a copy of child’s Birth Certificate and verification of address.

1. First and Last Name:(Required)

Individual’s date of birth:(Required)

2. First and Last Name:

Individual’s date of birth:

3. First and Last Name:

Individual’s date of birth:

4. First and Last Name:

Individual’s date of birth:

5. First and Last Name:

Individual’s date of birth:

6. First and Last Name:

Individual’s date of birth:

7. First and Last Name:

Individual’s date of birth:

8. First and Last Name:

Individual’s date of birth:

Does your child have an IFSP/IEP?(Required)

Yes

Does your child have any allergies?(Required)

Yes

(If yes, please provide information on the Emergency Form and complete an Allergy Action Plan. Have the doctor complete necessary sections.)

Is this child in Foster Care?(Required)

Yes

Is this child homeless?(Required)

Yes

Are there any medical or emotional concerns we should be aware of?(Required)

Yes

If yes, please explain:

What language(s) did your child first learn to speak?(Required)

What language(s) does your child use most often to communicate?(Required)

What language(s) are spoken in your home?(Required)

Attachments:

Drop files here or

Accepted file types: jpg, jpeg, png, pdf, doc, docx, heic, Max. file size: 300 MB.

1. Two consecutive pay stubs within the last 6 months OR 2022 tax returns (1040) OR 2022 W2s OR Unemployment Verification

Attachments:

Drop files here or

Accepted file types: jpg, jpeg, png, pdf, doc, docx, heic, Max. file size: 300 MB.

2. Child's Birth Certificate

Attachments:

Drop files here or

Accepted file types: jpg, jpeg, png, pdf, doc, docx, heic, Max. file size: 300 MB.

3. Verification of address (current property tax bill or utility bill or current rental lease)

Parent / Guardian Signature:(Required)

Date:(Required)

Enrollment Application for Public Pre-Kindergarten

Student Information

Family Information

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