2025-2026 Little Raiders Pre-k Enrollment

Pre-Kindergarten Application Form

2025-2026

We are excited to once again offer a full-day Pre-Kindergarten Program to our students! Please be sure to read through the general informaiton about the program on our website, here.

To secure a spot for your child, you will need to complete the form below and turn in the non-refundable $30.00 registration fee (cash or check can be mailed or dropped of at the elementary school or Corporation Office). Enrollment is on a first come, first serve basis. Once we are at capacity, this form will no longer be available, however, those interested may be placed on a wait list.

Additional information will be e-mailed to those who have registered in mid-March.
Child's First Name
Child's Middle Name
Child's Last Name
Child's Preferred Name (if different from above):
Child's Date of Birth (Must be 4 years old by August 1, 2024)

MonthDayYear
Date
Child's Sex
Parent(s)
Address
Email
example@example.com
Home
Cell
Work
What are some of your child's favorite activities?
Typically, how long does your child enjoy playing with a favorite toy?
What methods do you use to discipline your child?
What do you consider to be your child's strong points?
What do you consider to be your child's weaker areas?
Check the following tasks that your child can perform independently:

ToiletDressRemove CoatImaginative PlayWipe NoseFollow Simple InstructionsFeed Self
Check the following social skills that describe your child:

Is aware of other's feelingsTakes turns with othersInteracts with others in playRequires frequent adult attentionWill join in group activitiesSeparates easily from parents
Check the following language skills that describe your child:

Talks in sentencesListens to 5-10 minute storyParticipates in conversationsIs understood at least 75% of the time by an unfamiliar listener
Has your child been around children or adults with disabilities? Yes/No If yes, please explain.
What would you like your child to gain from the preschool experience?
Please explain any health concerns regarding your child (allergies, etc. ).
Additional Comments
$30.00 Non-Refundable Deposit

Cash or check (payable to SSC). Payment can be sent via mail or dropped off at the SSC Central Office (5100 North Raider Road, Middletown, IN 47356).
I confirm that the information provided on this application is complete and accurate. I have read through the information about the program on the Early Learning Website and agree to all conditions and payment agreements mentioned. I understand that I will need to provide payment for my child's spot to be reserved and also understand that the cost of the program is $50.00 per week.
Parent Signature

Clear
Date

MonthDayYear
Date
Should be Empty:

Pre-Kindergarten Application Form

2025-2026