The University of Texas Elementary School
1695450-4762500PRE-K New Student Application Form2020-2021__Tuition _____FederalA. Student InformationLast Name:___________________________________________________________________________First Name:___________________________________________________________________________Middle Name:________________________________________________________________________Birth Date:_______________________________ Age on September 1, 2020:______ Home Address:_________________________________________________ Zip Code:______________Home Phone: ________________________________ District of Residence:__________________________Previous School: _________________________ B. Parent/Legal Guardian InformationFull Name:________________________________________________ Relationship:________________Home Address:____________________________________________ Home Phone: _______________Employer: ________________________________________________ Work Phone: _______________Email Address: ____________________________________________ Cell: ______________________Language Preference: ______________________________________ Full Name:________________________________________________ Relationship:________________Home Address:____________________________________________ Home Phone: _______________Employer: ________________________________________________ Work Phone: _______________Email Address: ____________________________________________ Cell: ______________________Language Preference: _______________________________________ Please attach the following required documentation:Child’s Birth CertificateProof of Residency (full page of Electric Bill or Lease Agreement)Parent Picture IDPre-Kindergarten Application (Included)Home Language Survey (Complete at UTES)Application Fee ($30-TUITION ONLY) ORProof of Income (Current Pay Stub*/SNAP Eligibility Letter)*If you are paid weekly, you must provide your past two (2) pay stubs. Office Use Only (please use initials):615378557155180770-635 Stamp Received →Payment: Cash Check Check #________Time:_________ Notes: _________________________________________1704975635000Solicitud Para Estudiantes Nuevos al Pre-K2020-2021______ Tuición _______FederalA. Información Del EstudianteApellido:__________________________________________________________________________Primer Nombre:____________________________________________________________________Segundo Nombre:__________________________________________________________________Fecha de Nacimiento:__________________________ Edad en 9-1-20:______ Dirección:__________________________________________________ Código Postal:______________Teléfono: ________________________________ Distrito de Residencia:________________________B. Información de Padre de Familia/Guardián LegalNombre:______________________________________________________ Relación:________________Dirección:_____________________________________________________ Teléfono: _______________Empleo: ______________________________________________________ Teléfono: _______________Correo Electrónico : ____________________________________________ Celular: ________________Idioma Preferido: ______________________________________________ Nombre:______________________________________________________ Relación:________________Dirección:_____________________________________________________ Teléfono: _______________Empleo: ______________________________________________________ Teléfono: _______________Correo Electrónico : ____________________________________________ Celular: ________________Idioma Preferido: ______________________________________________ C. Proporcione por favor la siguiente documentación requerida:Certificado de Nacimiento del EstudiantePrueba de Residencia (Factura de luz, Contrato de Apartamento)Identificación de Padres/Guardián LegalAplicación de Pre-Kindergarten (Includia)Encuesta del Lengauje de Casa (Incluida)Cuota de Aplicación ($30) O Prueba de Recursos(Resumen de sueldo mensual*, carta de SNAP*Si se paga a la semana, debe entregar los dos (2) más recientes.Office Use Only (please use initials):615378557155180770-635 Stamp Received →Payment: Cash Check Check #________Time:_________Notes: _________________________________________ ................
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