2024-2025 Caldwell County Preschool Application

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WELCOME TO PRESCHOOL!

We are happy that you are applying for NCPK, Head Start, or tuition. Please fully read the information on each page.

Completing the application with take approximately 15-20 minutes. Please reserve enough time to complete the online application in one sitting.

If you prefer to complete a paper version, you will be able to print a copy following this page or you can pick up a copy at your local elementary school, Head Start/Northside Children's Learning Center, A New Beginning Child Care, Countryside Child Care, or at the Preschool Readiness Center, 332 Greenhaven Dr NW, Lenoir.

The first round of placements will occur in May 2024; However, applications are accepted year-round.

Please call us with questions at any time 828-726-3920.

TUITION - Tuition applications are now available. You may complete paper or electronic applications for elementary preschool classrooms. For the new high school learning lab preschools at South Caldwell High School and Hibriten High School, only paper applications are available at this time. Electronic forms for high school programs will be added at a later date. Please note that High School preschool classrooms are open from 7:15-4:15.
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I prefer to complete the application by* This field is required.
continuing the online application
printing a paper copy of the application
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English: You may print the NCPK/Head Start paper application here.Click Next for Spanish. Click Next for tuition application.
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Spanish: You may print the NCPK/Head Start paper application here.Click Next for tuition application.
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You may print the tuition application for Caldwell County Schools Elementary Preschool classrooms here.You may also elect to complete this application via this electronic app.
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Tuition Application for High School Learning Lab programs (paper only, not available as part of the electronic application at this time)
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Do you want to complete the online application?
YESNO
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Thank you for visiting the Caldwell County Schools preschool application portal. You can submit your application and supporting documents to the Preschool Readiness Center via mail, email, fax, or drop off. Address and contact information is on the last page of the application. Applications for CCS tuition slots are limited and on a first come, first serve basis. If are completing a tuition application and would like to also be considered for a NCPK/Head Start slot, please complete both a tuition and NCPK/Head Start application for consideration. Exit this document by closing your browser.
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You are completing this application on
Date
Month
Day
Year
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How old will your child be on August 31, 2024?* This field is required.This application is used for determining eligibility for both Head Start (3 and 4 year old) and NCPK (4 year old only). Those applying for tuition slots with Caldwell County Schools should also proceed with this application.
3 years old: Your child may be eligible for Head Start, but is not yet old enough for NCPK
4 years old: Your child may be eligible for Head Start and/or NCPK
3 or 4 years old: Check this box if you are ONLY applying for a tuition slot.
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Required Documents to Complete Application: CCS Tuition Application OnlyThis list of documentation is due before school starts for all children under a tuition slot with Caldwell County Schools. You will have an option to upload documents at the end of the application. If you elect not to upload documents, you may submit them via email, fax, or drop off. Details will be at the end of the application.
Copy of Child's Birth Certification
Copy of Legal Guardianship/Custody Paper, if applicable
Health Transmittal Form and Dental Form (Completed on or after September 2, 2023)
Up to Date Immunization/Shot Record
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Required Documents to Complete ApplicationThis is a list of the documentation required for your application to be processed. This list is for your information. You will have the option to upload these documents at the end of the online application. If you elect not to upload documents, you may submit them via email, fax, or drop off. Details will be at the end of the application.
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Child Information* This field is required.Please complete all information for the preschool child you are applying for. Twins will need a separate application completed.
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Child's Date of Birth* This field is required.
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Transportation and Before and After School Care Services are not included with these preschool programs.

The typical school day is from 8 am-2:30 pm, but may vary at certain schools because of school traffic patterns. This could mean starting as early as 7:30am and ending at 2pm.

Before and After School is only available through the community childcare sites: Head Start Program, A New Beginning Child Care, and Countryside Childcare. Parents should contact these centers directly to receive information regarding before and after-school availability and fees, if applicable.

Timely attendance is an expectation of the program. Prompt pick-up in the afternoon is required as our staff have afterschool responsibilities and are not available in classrooms beyond the scheduled times.
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If accepted into the program, my child would require before/after school care? I will contact one of the community sites to make arrangements.* This field is required.Caldwell County Schools does not currently have before/after school care for the preschool program. Community sites that do have this option are A New Beginning Childcare, Countryside Child Care, and Northside Children's Learning Center.
YESNO
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If accepted into the program, I will provide transportation or have other arrangements made.* This field is required.
YESNO
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If accepted into the program, I understand that timely arrival and departure are my responsibility. Initials* This field is required.
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Child's Gender* This field is required.
Boy
Girl
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Is your child Hispanic* This field is required.
YESNO
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County of Residence* This field is required.If Other, please enter the county of residence.
Caldwell
Burke
Catawba
Other
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You have selected a county of residence that is not Caldwell County. You may still apply for Caldwell County preschool slots; However, priority is given to residents of Caldwell. If you have questions, please feel free to contact the Preschool Readiness Center at 828-726-3920.
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What elementary school is your zoned school district (assigned)?* This field is required.
Baton
Collettsville
Davenport
Dudley Shoals
Gamewell
Granite Falls
Happy Valley
Hudson
King Creek
Lower Creek
Sawmills
Valmead
Whitnel
I do not know my elementary school district
I do not live in Caldwell County.
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Race (check all that apply)* This field is required.If Other is selected, please explain.
White
Black
Native American/Alaskan
Bi-Racial
Asian
Native Hawaiian/Pacific Islander
Other
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Is your child a NC resident?* This field is required.
YESNO
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Is your child a US citizen?* This field is required.
YESNO
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What language does your child most frequently use to communicate?* This field is required.
Arabic
Chinese
English
Spanish
Vietnamese/Hmong
Other
28
What language(s) are frequently used in home?* This field is required.Select all that apply. If Other is selected, please explain.
Arabic
Chinese
English
Spanish
Vietnamese
Vietnamese Hmong
Other
29
Child/family is currently being served by Child Protective Services* This field is required.
No
Yes, Currently in Foster Care
Yes, Currently resides with parent(s)
I am caring for a child who is awaiting foster care placement
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Please select all that apply to your child's current family status:* This field is required.
WIC
Food Stamps
Early Head Start
Medicaid
IEP/IFSP
Private Insurance
In foster care
In kinship care
Expecting a baby
N/A
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Is your family homeless (temporarily living with friends/family or in a shelter/car/hotel)?* This field is required.
No
Yes, more than 12 months
Yes, less than 12 months
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Current Living Situation:* This field is required.If Other is selected, please explain.
In a shelter
In own home
In your own home, rented home, or apartment
In a hotel or motel
With friends or relatives
Other
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Have you moved in the last 12 months? * This field is required.
Please Select
Please Select
Yes
No
If yes, please specify how many times and what were the circumstances for moving.
34
I am homeless and give Head Start (Blue Ridge Community Action) and/or Caldwell County Schools permission to make a referral for services.* This field is required.
YESNO
35
Income VerificationIn order for your application to be processed, we will need income verification information. Please check any boxes that you will be providing.
36
Who does your child live with at least 51% of the time?* This field is required.
Mother Only
Father Only
Mother/Stepmother and Father/Stepfather
Legal Guardian
Legal Custodian
Other
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Mother/Stepmother/Guardian's Name
Name
Please Select
Please Select
Mother
Stepmother
Guardian
Please tell us your relationship to the child.
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Mother/Stepmother/Guardian's Address
Street Address
Street Address Line 2
City
Postal/Zip Code
Home Phone
Cell/Mobile Phone
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Mother/Stepmother/Guardian's Email Address* This field is required.Emails are collected because information is sent on email first in order to quickly make notifications regarding your application.
example@example.com
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Mother/Guardian: Student StatusIf other is selected, please explain.
High School GED
College
Job Training Program
None
Other
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Mother/Stepmother/Guardian's IncomePlease check all sources of income. After this question, you will be asked about the specific amounts of income you receive from each source you select. All income must be verified with paystubs, benefits letters, or bank statements for NCPK and Head Start applications.
Employment Wages
Alimony
Child Support
Worker's Compensation
Unemployment
Work First/ TANF
Social Security
Social Security/Disability
VA Benefits
Pension/Annuity
Family Support
Other
42
Mother/Stepmother/Guardian: Are you currently employed?
YESNO
43
Mother/Stepmother/Guardian's IncomeBased on your answers, you currently have $0 income.
Please Select
Please Select
YES
NO
Is this correct?
How long have you had $0 income? Example: When was the last date you were employed?
44
Mother/Stepmother/Guardian: Please sign with full signature and date if you are unemployed and $0 income status. Full signature please
Clear
45
Employment Wages (mother, stepmother, guardian)Tell us how much you earn in your job. (Reminder: You must provide copies of the most recent two months' paystubs.)
Tell us how much your total pay is on your paystub.
Please Select
Please Select
Weekly
Bi-weekly
Twice per month
Monthly
How often do you get paid?
How many hours do you work in a pay period?
Employer
Employer Phone
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Social Security Disability If you receive Social Security Disability benefits, you will need to submit your most recent benefits letter.
Tell us how much your payments are.
Please Select
Please Select
Weekly
Bi-weekly
Twice per month
Monthly
How often do you get paid?
Who is the disability benefit for?
47
Family Support If you receive financial support from your family, verification of income may be a letter from the family member(s) stating the amount and frequency of payments. Such a letter must include the family member(s) name, address, and contact information.
Tell us how much your payments are.
Please Select
Please Select
Weekly
Bi-weekly
Twice per month
Monthly
How often do you receive support payments?
Family member(s) name and address who you will provide a letter from.
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Other Financial Support If you receive financial support other than those listed, please tell us about that income. Verification of this type of income will vary.
Tell us what kind of financial support you receive.
Tell us how much your payments are.
Please Select
Please Select
Weekly
Bi-weekly
Twice per month
Monthly
How often do you receive support?
49
Mother/Stepmother/Guardian Other IncomePlease tell us about your income. For each type of income you receive, you will need to submit verification which may include bank statements, paystubs, benefits letters, etc.
Income Received
Frequency of Payments
Payments Received By
Alimony
Row 0, Column 0
Row 0, Column 1
Row 0, Column 2
Child Support
Row 1, Column 0
Row 1, Column 1
Row 1, Column 2
Worker's Compensation
Row 2, Column 0
Row 2, Column 1
Row 2, Column 2
Unemployment
Row 3, Column 0
Row 3, Column 1
Row 3, Column 2
WorkFirst/TANF
Row 4, Column 0
Row 4, Column 1
Row 4, Column 2
Social Security Retirement
Row 5, Column 0
Row 5, Column 1
Row 5, Column 2
VA Benefits
Row 6, Column 0
Row 6, Column 1
Row 6, Column 2
Pension/Annuity
Row 7, Column 0
Row 7, Column 1
Row 7, Column 2
Alimony
Child Support
Worker's Compensation
Unemployment
WorkFirst/TANF
Social Security Retirement
VA Benefits
Pension/Annuity
Income Received
Row 0, Column 0
Frequency of Payments
Row 0, Column 1
Payments Received By
Row 0, Column 2
Income Received
Row 1, Column 0
Frequency of Payments
Row 1, Column 1
Payments Received By
Row 1, Column 2
Income Received
Row 2, Column 0
Frequency of Payments
Row 2, Column 1
Payments Received By
Row 2, Column 2
Income Received
Row 3, Column 0
Frequency of Payments
Row 3, Column 1
Payments Received By
Row 3, Column 2
Income Received
Row 4, Column 0
Frequency of Payments
Row 4, Column 1
Payments Received By
Row 4, Column 2
Income Received
Row 5, Column 0
Frequency of Payments
Row 5, Column 1
Payments Received By
Row 5, Column 2
Income Received
Row 6, Column 0
Frequency of Payments
Row 6, Column 1
Payments Received By
Row 6, Column 2
Income Received
Row 7, Column 0
Frequency of Payments
Row 7, Column 1
Payments Received By
Row 7, Column 2
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Father/Stepfather/Guardian's Name
First Name
Last Name
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Father/Stepfather/Guardian's Address
Street Address
Street Address Line 2
City
Postal/Zip Code
Home Phone
Cell/Mobile Phone
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Father/Stepfather/Guardian's Email* This field is required.Emails are collected because information is sent on email first in order to quickly make notifications regarding your application. (If child lives primarily with mother, please enter mother's email address again.)
example@example.com
53
Father/Guardian: Student StatusIf other is selected, please explain.
High School GED
College
Job Training Program
None
Other
54
Father/Stepfather/Guardian's IncomePlease check all sources of income. After this question, you will be asked about the specific amounts of income you receive from each source you select. All income must be verified with paystubs, benefits letters, or bank statements for NCPK and Head Start applications.
Employment Wages
Alimony
Child Support
Worker's Compensation
Unemployment
Work First/ TANF
Social Security
Social Security/Disability
VA Benefits
Pension/Annuity
Family Support
Other
55
Father/Guardian: Are you currently employed?
YESNO
56
Father/Stepfather/Guardian's IncomeBased on your answers, you currently have $0 income.
Please Select
Please Select
YES
NO
Is this correct?
How long have you had $0 income? Example: When was the last date you were employed?
57
Father/Stepfather/Guardian: Please sign with full signature and date if you are unemployed and have $0 income.Full signature please
Clear
58
Employment Wages (father, stepfather, guardian)Tell us how much you earn in your job. (Reminder: You must provide copies of the most recent two months' paystubs.)
Tell us how much your total pay is on your paystub.
Please Select
Please Select
Weekly
Biweekly/Every other week
Twice per month
Monthly
How often do you get paid?
How many hours do you work in a pay period?
59
Social Security Disability If you receive Social Security Disability benefits, you will need to submit your most recent benefits letter.
Tell us how much your payments are.
Please Select
Please Select
Option 1
Option 2
Option 3
How often do you get paid?
Who is the disability benefit for?
60
Family Support If you receive financial support from your family, verification of income may be a letter from the family member(s) stating the amount and frequency of payments. Such a letter must include the family member(s) name, address, and contact information.
Tell us how much your payments are.
Please Select
Please Select
Weekly
Biweekly/Every other week
Twice per month
Monthly
How often do you receive support?
61
Other Financial Support If you receive financial support other than those listed, please tell us about that income. Verification of this type of income will vary.
Tell us what kind of financial support you receive.
Tell us how much your payments are.
Please Select
Please Select
Weekly
Biweekly/Every other week
Twice per month
Monthly
How often do you receive support?
62
Father/Stepfather/Guardian Other IncomePlease tell us about your income. For each type of income you receive, you will need to submit verification which may include bank statements, paystubs, benefits letters, etc.
Income Received
Frequency of Payments
Payments Received By
Alimony
Row 0, Column 0
Row 0, Column 1
Row 0, Column 2
Child Support
Row 1, Column 0
Row 1, Column 1
Row 1, Column 2
Worker's Compensation
Row 2, Column 0
Row 2, Column 1
Row 2, Column 2
Unemployment
Row 3, Column 0
Row 3, Column 1
Row 3, Column 2
WorkFirst/TANF
Row 4, Column 0
Row 4, Column 1
Row 4, Column 2
Social Security Retirement
Row 5, Column 0
Row 5, Column 1
Row 5, Column 2
VA Benefits
Row 6, Column 0
Row 6, Column 1
Row 6, Column 2
Pension/Annuity
Row 7, Column 0
Row 7, Column 1
Row 7, Column 2
Alimony
Child Support
Worker's Compensation
Unemployment
WorkFirst/TANF
Social Security Retirement
VA Benefits
Pension/Annuity
Income Received
Row 0, Column 0
Frequency of Payments
Row 0, Column 1
Payments Received By
Row 0, Column 2
Income Received
Row 1, Column 0
Frequency of Payments
Row 1, Column 1
Payments Received By
Row 1, Column 2
Income Received
Row 2, Column 0
Frequency of Payments
Row 2, Column 1
Payments Received By
Row 2, Column 2
Income Received
Row 3, Column 0
Frequency of Payments
Row 3, Column 1
Payments Received By
Row 3, Column 2
Income Received
Row 4, Column 0
Frequency of Payments
Row 4, Column 1
Payments Received By
Row 4, Column 2
Income Received
Row 5, Column 0
Frequency of Payments
Row 5, Column 1
Payments Received By
Row 5, Column 2
Income Received
Row 6, Column 0
Frequency of Payments
Row 6, Column 1
Payments Received By
Row 6, Column 2
Income Received
Row 7, Column 0
Frequency of Payments
Row 7, Column 1
Payments Received By
Row 7, Column 2
1 of 8
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Is at least one parent/guardian of this child is currently an active duty member of the United States Armed Forces; or was ordered active duty within the last 18 months or expected to be ordered within the next 18 months; or has been seriously injured or killed in active duty?* This field is required.If yes, please provide documentation.
YESNO
64
Family Headcount* This field is required.Please list all family members living in the household (include step-parents) including those who are dependents (including step-siblings).
Name
Birthdate
Current Age
Relationship to Preschool Child
1
Row 0, Column 0
Row 0, Column 1
Row 0, Column 2
Row 0, Column 3
2
Row 1, Column 0
Row 1, Column 1
Row 1, Column 2
Row 1, Column 3
3
Row 2, Column 0
Row 2, Column 1
Row 2, Column 2
Row 2, Column 3
4
Row 3, Column 0
Row 3, Column 1
Row 3, Column 2
Row 3, Column 3
5
Row 4, Column 0
Row 4, Column 1
Row 4, Column 2
Row 4, Column 3
6
Row 5, Column 0
Row 5, Column 1
Row 5, Column 2
Row 5, Column 3
7
Row 6, Column 0
Row 6, Column 1
Row 6, Column 2
Row 6, Column 3
8
Row 7, Column 0
Row 7, Column 1
Row 7, Column 2
Row 7, Column 3
9
Row 8, Column 0
Row 8, Column 1
Row 8, Column 2
Row 8, Column 3
10
Row 9, Column 0
Row 9, Column 1
Row 9, Column 2
Row 9, Column 3
1
2
3
4
5
6
7
8
9
10
Name
Row 0, Column 0
Birthdate
Row 0, Column 1
Current Age
Row 0, Column 2
Relationship to Preschool Child
Row 0, Column 3
Name
Row 1, Column 0
Birthdate
Row 1, Column 1
Current Age
Row 1, Column 2
Relationship to Preschool Child
Row 1, Column 3
Name
Row 2, Column 0
Birthdate
Row 2, Column 1
Current Age
Row 2, Column 2
Relationship to Preschool Child
Row 2, Column 3
Name
Row 3, Column 0
Birthdate
Row 3, Column 1
Current Age
Row 3, Column 2
Relationship to Preschool Child
Row 3, Column 3
Name
Row 4, Column 0
Birthdate
Row 4, Column 1
Current Age
Row 4, Column 2
Relationship to Preschool Child
Row 4, Column 3
Name
Row 5, Column 0
Birthdate
Row 5, Column 1
Current Age
Row 5, Column 2
Relationship to Preschool Child
Row 5, Column 3
Name
Row 6, Column 0
Birthdate
Row 6, Column 1
Current Age
Row 6, Column 2
Relationship to Preschool Child
Row 6, Column 3
Name
Row 7, Column 0
Birthdate
Row 7, Column 1
Current Age
Row 7, Column 2
Relationship to Preschool Child
Row 7, Column 3
Name
Row 8, Column 0
Birthdate
Row 8, Column 1
Current Age
Row 8, Column 2
Relationship to Preschool Child
Row 8, Column 3
Name
Row 9, Column 0
Birthdate
Row 9, Column 1
Current Age
Row 9, Column 2
Relationship to Preschool Child
Row 9, Column 3
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Alternative Contacts* This field is required.At least one alternative contact my be provided.
Contact's Name
Phone during the day
Relationship to the family
1
Row 0, Column 0
Row 0, Column 1
Row 0, Column 2
2
Row 1, Column 0
Row 1, Column 1
Row 1, Column 2
3
Row 2, Column 0
Row 2, Column 1
Row 2, Column 2
4
Row 3, Column 0
Row 3, Column 1
Row 3, Column 2
1
2
3
4
Contact's Name
Row 0, Column 0
Phone during the day
Row 0, Column 1
Relationship to the family
Row 0, Column 2
Contact's Name
Row 1, Column 0
Phone during the day
Row 1, Column 1
Relationship to the family
Row 1, Column 2
Contact's Name
Row 2, Column 0
Phone during the day
Row 2, Column 1
Relationship to the family
Row 2, Column 2
Contact's Name
Row 3, Column 0
Phone during the day
Row 3, Column 1
Relationship to the family
Row 3, Column 2
1 of 4
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Does your child have a physical challenge or chronic illness?* This field is required.*A medical diagnosis is required. Verification from your child's physician must be provide with the application. If Other is selected, please explain.
No
asthma
diabetes
obesity
anemia
Other
67
Does your child have a developmental or educational need?* This field is required.
Please Select
Please Select
Yes
No
If you selected YES, please tell us about your child's developmental or educational needs.
68
Has your child has recently had a developmental screening?* This field is required.
No. My child has not had a developmental screening.
Yes. My child has had a developmental screening. (Please check this response and enter the date below)
Other
69
Testing: Has your child been referred or recommended for testing to determine if services are needed to help developmental or educational needs?
Yes
No
Not referred, but I have concerns.
Speech Therapy
Row 0, Column 0
Row 0, Column 1
Row 0, Column 2
Physical Therapy
Row 1, Column 0
Row 1, Column 1
Row 1, Column 2
Occupational Therapy
Row 2, Column 0
Row 2, Column 1
Row 2, Column 2
Play Therapy
Row 3, Column 0
Row 3, Column 1
Row 3, Column 2
Counseling
Row 4, Column 0
Row 4, Column 1
Row 4, Column 2
Other
Row 5, Column 0
Row 5, Column 1
Row 5, Column 2
Speech Therapy
Physical Therapy
Occupational Therapy
Play Therapy
Counseling
Other
Yes
Row 0, Column 0
No
Row 0, Column 1
Not referred, but I have concerns.
Row 0, Column 2
Yes
Row 1, Column 0
No
Row 1, Column 1
Not referred, but I have concerns.
Row 1, Column 2
Yes
Row 2, Column 0
No
Row 2, Column 1
Not referred, but I have concerns.
Row 2, Column 2
Yes
Row 3, Column 0
No
Row 3, Column 1
Not referred, but I have concerns.
Row 3, Column 2
Yes
Row 4, Column 0
No
Row 4, Column 1
Not referred, but I have concerns.
Row 4, Column 2
Yes
Row 5, Column 0
No
Row 5, Column 1
Not referred, but I have concerns.
Row 5, Column 2
1 of 6
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Referral for Testing to Determine Developmental or Educational NeedPlease tell us about testing completed for therapies and services for your child including the type of service and which agency is providing those services.
71
What services is your child receiving for a developmental or educational need?
Current Services
Previous Services
Never
Speech Therapy
Row 0, Column 0
Row 0, Column 1
Row 0, Column 2
Occupational Therapy
Row 1, Column 0
Row 1, Column 1
Row 1, Column 2
Physical Therapy
Row 2, Column 0
Row 2, Column 1
Row 2, Column 2
Play Therapy
Row 3, Column 0
Row 3, Column 1
Row 3, Column 2
Counseling
Row 4, Column 0
Row 4, Column 1
Row 4, Column 2
Other
Row 5, Column 0
Row 5, Column 1
Row 5, Column 2
Speech Therapy
Occupational Therapy
Physical Therapy
Play Therapy
Counseling
Other
Current Services
Row 0, Column 0
Previous Services
Row 0, Column 1
Never
Row 0, Column 2
Current Services
Row 1, Column 0
Previous Services
Row 1, Column 1
Never
Row 1, Column 2
Current Services
Row 2, Column 0
Previous Services
Row 2, Column 1
Never
Row 2, Column 2
Current Services
Row 3, Column 0
Previous Services
Row 3, Column 1
Never
Row 3, Column 2
Current Services
Row 4, Column 0
Previous Services
Row 4, Column 1
Never
Row 4, Column 2
Current Services
Row 5, Column 0
Previous Services
Row 5, Column 1
Never
Row 5, Column 2
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Does your child have a current IEP (Individualized Education Plan) or IFSP (Individual Family Service Plan)?* This field is required.If your child has an IEP through a school system other than Caldwell County Schools, you will need to provide a copy of the most recent IEP.
No.
Yes. My child has a current IEP through Caldwell County Schools.
Yes. My child has a current IEP through a different school system.
Other
73
Does your child have a sibling who is currently being serviced under an Individualized Education Plan (IEP) or Individualized Family Service Plan (IFSP)?
Please Select
Please Select
Yes
No
I'm not sure
What school district provides IEP services for the sibling.
Full Name of the sibling with an IEP.
74
My child has attended a child care center or family care home.
Please Select
Please Select
Attending currently, paid by family
Attending currently, paid by subsidy voucher
Attended previously but is not currently enrolled in a child care setting
Never
If your child is not currently attending a child care setting, please tell us who attends your child during the day.
75
Child Care Information
Name of CURRENT child care center/home child care
Start Date
Number of hours attending weekly
Name of PREVIOUS child care center/home child care
End Date
Number of hours attended weekly
76
Subsidy/Childcare Voucher
Please Select
Please Select
Yes
No
Have you applied for subsidy and are on a wait list?
Please Select
Please Select
Yes
No
Are you eligible for subsidy?
77
What other family circumstances should be considered for this child's enrollment.
Currently in the home
Not in the home
Parental substance abuse
Row 0, Column 0
Row 0, Column 1
Parent currently incarcerated
Row 1, Column 0
Row 1, Column 1
Parent released from incarceration within the last 6 months
Row 2, Column 0
Row 2, Column 1
Diagnosed parental physical illness/disability
Row 3, Column 0
Row 3, Column 1
Diagnosed parental mental illness
Row 4, Column 0
Row 4, Column 1
Domestic violence
Row 5, Column 0
Row 5, Column 1
Other
Row 6, Column 0
Row 6, Column 1
Parental substance abuse
Parent currently incarcerated
Parent released from incarceration within the last 6 months
Diagnosed parental physical illness/disability
Diagnosed parental mental illness
Domestic violence
Other
Currently in the home
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Not in the home
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Currently in the home
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Not in the home
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Currently in the home
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Not in the home
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Currently in the home
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Not in the home
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Currently in the home
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Not in the home
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Currently in the home
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Not in the home
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Currently in the home
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How often do you read to your child?
Daily
3-5 times per week
1-2 times per week
a few times per month
occasionally
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My child does not receive free Dolly Parton Imagination Library books. Please enroll him/her through Caldwell Smart Start.
YESNO
80
Signature and DateBy providing your signature, you are giving permission to Caldwell County Schools to share the needed information (name, age, address, county of residence) to enroll your child in Dolly Parton's Imagination Library. Necessary information will be shared only with Caldwell Smart Start, the Dolly Parton Imagination Library provider for Caldwell County.
Clear
81
Please carefully read the following statements and confirm your understanding.* This field is required.
Yes
No
I understand that by completing this application, my child is not guaranteed placement and that he/she may be on a waiting list.
Row 0, Column 0
Row 0, Column 1
I understand that if my child is selected for participation, family involvement is essential. My family will cooperate with programs to submit the necessary documentation and application for additional services.
Row 1, Column 0
Row 1, Column 1
I understand that transportation to and from Pre-K programs will be my family's responsibility.
Row 2, Column 0
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I understand that my child will receive a developmental screening in the primary language listed in the application and give permission for my child to also receive vision, hearing, dental, and/or speech and language screenings.
Row 3, Column 0
Row 3, Column 1
I understand that if there is a change in my child's address, phone number, or attendance in any type of licensed care, or if there is a change in family income, it is my responsibility to notify the Caldwell County Schools Preschool Readiness Center and inform them of any changes.
Row 4, Column 0
Row 4, Column 1
I understand that my child will need a current, updated health assessment which includes dental, vision, hearing and an updated immunization record, before she/he attends a program. (Health Transmittal form for NC is available in most Caldwell County doctor's offices.)
Row 5, Column 0
Row 5, Column 1
I understand that, if my child is accepted into the NC Pre-Kindergarten Program and/or Head Start, regular attendance is required for full benefit of the program. Failure to maintain regular attendance could jeopardize his/her placement in the program.
Row 6, Column 0
Row 6, Column 1
I understand that my child's progress will be shared with his anticipated kindergarten school to help the school prepare for a successful transition for may child. Information may include his screenings and data collected in the NCPK/Head Start classroom.
Row 7, Column 0
Row 7, Column 1
I understand that by completing this application, my child is not guaranteed placement and that he/she may be on a waiting list.
I understand that if my child is selected for participation, family involvement is essential. My family will cooperate with programs to submit the necessary documentation and application for additional services.
I understand that transportation to and from Pre-K programs will be my family's responsibility.
I understand that my child will receive a developmental screening in the primary language listed in the application and give permission for my child to also receive vision, hearing, dental, and/or speech and language screenings.
I understand that if there is a change in my child's address, phone number, or attendance in any type of licensed care, or if there is a change in family income, it is my responsibility to notify the Caldwell County Schools Preschool Readiness Center and inform them of any changes.
I understand that my child will need a current, updated health assessment which includes dental, vision, hearing and an updated immunization record, before she/he attends a program. (Health Transmittal form for NC is available in most Caldwell County doctor's offices.)
I understand that, if my child is accepted into the NC Pre-Kindergarten Program and/or Head Start, regular attendance is required for full benefit of the program. Failure to maintain regular attendance could jeopardize his/her placement in the program.
I understand that my child's progress will be shared with his anticipated kindergarten school to help the school prepare for a successful transition for may child. Information may include his screenings and data collected in the NCPK/Head Start classroom.
Yes
Row 0, Column 0
No
Row 0, Column 1
Yes
Row 1, Column 0
No
Row 1, Column 1
Yes
Row 2, Column 0
No
Row 2, Column 1
Yes
Row 3, Column 0
No
Row 3, Column 1
Yes
Row 4, Column 0
No
Row 4, Column 1
Yes
Row 5, Column 0
No
Row 5, Column 1
Yes
Row 6, Column 0
No
Row 6, Column 1
Yes
Row 7, Column 0
No
Row 7, Column 1
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I give permission for my child’s name, picture, portrait, likeness, or voice to be used for the purpose of classroom center display, classroom scrapbook, newspaper articles, television broadcast, posting to Pre-K program websites, and/or printed materials for use by the Caldwell County Schools.* This field is required.
YESNO
83
Are you interested in free classes to earn a high school equivalency diploma or to learn English?Caldwell County Family Literacy is an adult education program where you can earn a high school equivalency and/or English.
Please Select
Please Select
Yes
No
Please Select
Please Select
High School Equivalency
Learning English
Both
Which program are you interested in learning more about?
84
I give permission for my name and contact information to be shared with Caldwell County Family Literacy regarding adult education programs that may benefit my family.* This field is required.
YESNO
85
Preferred Location- Please choose your first, second, third, and fourth choice for location by arranging your preferred locations in order (drag them to the top and put them in order 1-4 of your preference). Please remember that while every effort will be made to place eligible children in preferred locations, we are unable to guarantee a site Sites below are subject to change due to funding and availability.* This field is required.**Applicants only interested in Head Start will need to select Northside Children's Learning Center as their first choice.
86
Do you have documents that you would like to upload now? * This field is required.
YESNO
87
Child's Birth CertificateYou may upload a copy of your child's birth certificate here. (All uploaded documents must be clear and legible.)
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
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Child's Health FormThe health form is completed by your child's doctor. To be valid for the 2023-2024 school year, your child's visit must occur on or after September 1, 2023.
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
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Child's ImmunizationYou may upload your child's most recent immunization record here.
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
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90
Family Income (not necessary for tuition-only applications)You may upload multiple files related to family income here.
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
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Child CustodyIf a custody agreement or court order are in place for your child, you may submit a copy here.
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
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Other InformationAny additional information you would like to submit may be included here. (Example: medical diagnosis, confirmation of therapy records, IEP from a county other than Caldwell, etc.)
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
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93
Please let us know if you have questions and would like someone to contact you.
Please Select
Please Select
Yes
No
Do you want someone to contact you?
What is the best phone number to reach you?
What is/are your questions concerning?
94
Please tell us who completed this application.* This field is required.
Name
Relationship to the child
95
I certify that all information provided in this application is true, correct, and complete. I understand that information is provided to document eligibility for receipt of program funds. Program staff may verify information on this application. Deliberate misrepresentation may subject me to prosecution under applicable state laws.Please Sign
Clear
96
Application Confirmation EmailWhat email do you want a confirmation sent to?
example@example.com
97
Thank you for visiting the Caldwell County Schools preschool application portal.

You can submit your application and supporting documents to the Preschool Readiness Center via mail, email, fax, or drop off. Applications for tuition slots are limited and on a first come, first serve basis. NCPK/Head Start slots have requirements for funding.

Preschool Readiness Center

332 Greenhaven Dr NW

Lenoir NC 28645

828-726-3920

828-754-0642 fax

lacoffey@caldwellschools.com

All applicants will be contacted if documentation is missing. Upon acceptance into the program, you will be notified. The earliest acceptance will be in late May. Remaining slots will be notified as applicants are verified for funding.
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Type a question
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