UNIVERSITY PLACE SCHOOL DISTRICT Fax: 253-566-5607 ...

FORMS MUST BE RETURNED TO EDUCATIONAL SERVICE CENTER ONLY

UNIVERSITY PLACE SCHOOL DISTRICT

Educational Service Center 3717 Grandview Dr. West University Place, WA 98466-2138

Phone 253-566-5600 Fax: 253-566-5607

Integrated Community Preschool Application Form

2020-2021

What is the Integrated Preschool Program?

This is a tuition-based, half-day program offered 4 days per week for 4 year olds that are 5 by 8/31/2021 and for 3 year

olds that are 3 by 8/31/20. Children in the Integrated Community Preschool Program have the opportunity to work and

play with age appropriate peers who have similar developmental levels as well as peers with developmental challenges.

~ALL PRESCHOOL CLASSES ARE HELD AT SUNSET PRIMARY ~

If you are interested in the Integrated Community Preschool Program for your child, please complete this form and

return to the Educational Service Center (ESC), at the address noted above. Do not return it to the school site.

Student Legal Name: Address:

Parent/Guardian Name: E-Mail Address:

Male Female

Date of Birth

Home Phone Number: Work / Cell Number

Eligibility Criteria: 1) Child must be 4 by August 31st, 2020. Placement of 4 year old children that will turn 5 by 8/31/2021 will be given priority. 2) Children who are 3 by August 31st, 2020 will be placed based on seats available 3) Child must be toilet trained 4) Parent must be able to transport the child to and from the program. No busing services are available. 5) Address verification required with current utility bill

AM session meets from 8:00 a.m. -10:30 a.m. PM session meets from 11:45 a.m. to 2:15 p.m.

Monthly Tuition 4 days per week (M,T,TH,F)

$ 270.00 Full Tuition $ 135.00 Reduced 1 Tuition** $ 67.50 Reduced 2 Tuition**

**To be considered for a full or partial Tuition Scholarship, please complete the "Fee Reduction" application attached.

We will begin accepting applications on March 24th, 2020. Notification of program placement will begin the last week of May. Please note: Completing this form does not guarantee placement in the Integrated Community Preschool Program. Student placement will be based on program availability.

- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -

I understand that if my student is accepted to attend the Integrated Preschool program in UPSD, tuition must be paid by the specified due date. Past due tuition may result in my child being removed from the program. A deposit equal to one month's tuition will be required once the student is accepted into the program and will be applied toward the first month's tuition.

Parent Signature _________________________________________________

Date _______________________

Submitted to: ____________________________

Tuition Rate Full Reduced 1 Reduced 2

District Use Only

Accepted: yes no

Date:_____________________

Administrator Signature: _____________________________________

 ................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download