First Class Pre-K School Application Form

Madison City Schools First Class Pre-K Online Application
Children must be four years old on or before September 1st, 2016. Copies of the following documents are required: age verification document (for example: birth certificate, passport, official documents from other countries), proof of residency.
Student's Full Name*
First NameMiddle NameLast Name
Student's Date of Birth*
MonthDayYear
Gender*
Primary Custodial Parent/Guardian*
PrefixFirst NameMiddle NameLast Name
Address*
Street Address
Street Address Line 2
CityState / Province
Postal / Zip CodeCountry
Home Phone
Area CodePhone Number
Cell Phone
Area CodePhone Number
Work Phone
Area CodePhone Number
Contact E-mail
Child physically resides with*
Mother and FatherMotherFatherGrandparentOther
# of Persons in Household*
Language Spoken at Home*
EnglishSpanishOther
Other Language*
What is the student's race?*
American Indian or Alaska NativeAsianBlack or African AmericanHispanicWhite
Highest Education In Household*
Family's Combined Annual Income*
Do you receive public assistance?
YesNo
If yes, please select type of assistance*
SSIDisabilityWICFood StampsTANFOther
Other Assistance
Should be Empty: