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. For your application to be considered, you must complete this application and attach ALL required documents. Applications without required documents will not be processed until we receive them.

Drop your verification documents off at The Learning Bee Office, 8311 River Run Rd, Frederick, MD 21701. Or place them in the mail if you are unable to drop off.

Required Documents Include:
1. 6 weeks of pay stubs within the last 6 months OR 2023 tax returns (1040) OR 2023 W2s OR Unemployment Verification for all adult members living in the household
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)

Race: (Check all that apply) (Required)

American Indian/Alaskan Native

Asian

Black or African American

White

Native Hawaiian or Pacific Islander

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)

Bring your qualification documents to The Learning Bee for review or mail them to:

The Learning Bee
8311 River Run Rd.
Frederick, MD 21701

If you do not have access to a copier, we can make copies for you at The Learning Bee.

Parent / Guardian Signature:(Required)

Date:(Required)

Enrollment Application for Public Pre-Kindergarten

Student Information

Family Information

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