K5-5th grade Pre-Application Form 2025-2026

K5 - 5th grade Pre-Application Form | 2025-26 School Year

STUDENT MUST BE OF APPROPRIATE AGE FOR DESIGNATED GRADE LEVEL BY SEPT. 1ST, 2025
Student's Information
Grade Applying For *
Student's Full Name*
Date of Birth*

MonthDayYear
Date
Gender*

MaleFemale
Ethnicity*

HispanicNon-Hispanic
Race*

AsianBlack/African-AmericanWhiteOther
English Proficiency*

Very wellWellDoes not speak EnglishOther
Does your child have an IEP (Individual Educational Plan) or 504 Plan?*

YesNo
(Disclosure Statement: This information is being sought for program planning purposes related to staffing and budgeting, not to determine the student's enrollment status)
Are you concerned about your child’s behavior, speech, emotional or academic?*

YesNo
If yes, please specify*
Current School*
Current grade level*
Child resides with*

Both parentsMotherFatherGuardianKinshipFoster careOther
Parent/Guardian Information
1st Parent/ Guardian's Full Name *
(Adult who is completing this application)
Primary Language*
Address*

Address

Street Address Line 2

CityState / Province

Zip Code
Phone Numbers:*
Please enter a valid phone number.
Alternate Phone Number
Please enter a valid phone number.
Email address*
example@example.com
Best time to contact you*
2nd Parent/ Guardian's Full Name
(Adult who is completing this application)
Primary Language
Address

Address

Street Address Line 2

CityState / Province

Zip Code
Phone Numbers: Home/Cellular
Alternate
Email address
example@example.com
Best time to contact you
Family Information
Family Unit Size*
(example: 2 children + 1 parent = 3)
Are there sibling(s) who(se) currently attend UCC schools?*

YesNo
If yes, please list each child:
First Name Last Name Grade Teacher
First Name Last Name Grade Teacher
First Name Last Name Grade Teacher
Are you applying for other children this academic school year?*

YesNo
If yes, please list each child:
First Name Last Name Grade
First Name Last Name Grade
How did you hear about UCC schools?*

I'm currently a UCC familyI'm a UCC EmployeeWord of mouth (friend-family)Walked/drove by the centerPorter/flyerKnow someone who works hereReferred by agencyWebsite/Google SearchOther
NOTE: Completing this application does not signify that your child will be automatically enrolled at UCC Bruce Guadalupe Elementary School. You submit all required documents along with this application for your child to be considered for selection. Depending on available positions, we will ONLY contact you to attend an information meeting. All submitted documents will be destroyed by October 17th, 2025, unless your child is accepted into the program. Iunderstand that if my child is accepted at UCC Bruce Guadalupe Elementary School, all school rules, including attendance and dress code guidelines and parent engagement expectations, will be followed.
ParentGuardian Signature*

Clear
Date*

MonthDayYear
Date
Should be Empty:

K5 - 5th grade Pre-Application Form | 2025-26 School Year