Preschool Registration

HOPE Preschool 2023-2024 Registration Form
- Child must be toilet trained by August 1, 2023.
- Birth Certificate must accompany a non-refundable registration fee of $150.
- Nine (9) consecutive payments begin in AUGUST and continue through APRIL.
  - The August payment is non-refundable.
  - The August payment may not be applied to any future month’s payment.
- Sandra Rolston Scholarship ~ Financial need-based scholarship applications are available upon request.
Student Information
Last Name*
First Name*
Birth Date*

MonthDayYear
Gender*

FM
Parent/Guardian Information
Full Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Has anyone in your immediate family ever attended HOPE Preschool?*

YesNo
Primary Phone #:
Primary Number*

Area CodePhone Number
Primary Phone # Type:*
Alternate Phone Number

Area CodePhone Number
Alternate Phone #:
Alternate Phone # Type:
E-mail*
Placement Information
Is your child diagnosed with food allergies?*

YesNo
If yes, please list food allergies
Does your child have an EpiPen Jr.?*

YesNo
Does your child have an Auvi-Q?*

YesNo
Does your child have an inhaler?*

YesNo
Is your child receiving, referred for, or attending any supplemental services/programs? (Please Check All That Apply)

SpeechOTPTIEPVISIONOther
(FOR PLACEMENT PURPOSES ONLY) Is English your child’s primary language?*

YesNo
Can your child express his/her needs in English?*

YesNo
Are there any Chronic Physical Conditions, Developmental Information, Special Accommodations:
Comments
Class Preferences

Please review the list of available regular class options (A - H) and select a first, second, and third choice from the drop down boxes below. Enrichment class options (I and J) are only in addition to regular class options.
First Choice*
Second Choice*
Third Choice*
Check I or J if wanting to register for Language & Literature Enrichment classes

Class I (this class no longer available)Class J
All registrations are received and reviewed in a first come, first serve basis. Upon filling all open spots, all additional submissions will be added to our waiting list.
Signature*

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HOPE Preschool 2023-2024 Registration Form

Student Information

Parent/Guardian Information

Placement Information

Class Preferences