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School Readiness Interest Form

Please complete the form below. Required fields marked with an asterisk *

Please Select Year to Enroll*

Answer Required

2023-24 Current Year

2024-25 Upcoming Year

Child's Name*

Nombre de su hijo/a

Answer Required

Child's D.O.B*

Fecha de nacimiento

Answer Required

Parent's Name*

Nombre de Padre/Madre

Answer Required

Phone Number*

Numero de teléfono

Number Required

Parent Email*

Correo electrónico de los padres

Answer Required

Street Address*

Domicilio

Answer Required

Apt Number

Apartamento

Answer Required

City*

Ciudad

Answer Required

Zip/Postal*

Codigo Postal

Answer Required

Family Size*

Numero de miembros de familia

Answer Required

Home Language*

Idioma del hogar

Answer Required

Since our program is state funded, gross monthly income verification is required. Additional documents will be required for completing registration.

Dado que nuestro programa está financiado por el estado, se requiere la verificación del ingreso bruto mensual. Se requerirán documentos adicionales para completar el registro.

Gross Monthly Income*

Ingreso mensual en bruto

Answer Required