Clone of RELC Re-Evaluation Form 2025

Reid Early Learning Center 2026-2027 Interest Form

To qualify for Reid Early Learning Center, families must provide the following documentation: page 1 and 2 of the 2025 1040 tax form, a W-2, a copy of the child's birth certificate, and a copy of a utility bill with the parent's name and address that matches the name and address listed on the tax return. All income earners in the household must submit proof of earnings. Please answer each question honestly. Falsified documents will be flagged for review by MSDE and will result in immediate dismissal from the program.
Personal Information
Child's Name

Last NameFirst Name
Parent 1 Name

Last NameFirst Name
Parent 2 Name

Last NameFirst Name
Email
example@example.com
Child's Primary Home Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Birth Date

MonthDayYear
Demographic Information
Place of Birth
Gender Identity

Other
Ethnicity
Nationality
Language Survey
Please list all languages spoken in the home.
What language did the child first learn to speak?
What language does the child speak most often?
How many total members reside in the child's primary home address listed above? (This includes legal guardians, grandparents, non-immediate family members, and siblings.)
Income earner #1: Upload income documentation for income earned in 2025 (includes 2025 tax returns, paystubs, W-2's, or unemployment earnings.)

Upload documentation for each income earning member in the household listed above.
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Income earner #2: Upload income documentation for income earned in 2025 (includes 2025 tax returns, paystubs, W-2's, or unemployment earnings.)

Upload documentation for each income earning member in the household listed above.
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Are there 3 or more income earners in your household? If answered yes, email their income information directly to mtaylor@reidtempleacademy.com
Upload Child's Birth Certificate

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Upload Copy of Utility Bill

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I certify, by my signature, that the information contained within this application and all supporting documents (i.e., paystubs, W-2, 1040 tax forms) is true, accurate, and complete to the best of my knowledge.

I understand that if any part of this application is found to be falsified, I may be subject to legal consequences and required to reimburse Reid Temple Christian Academy for any educational services my child has received. An electronic signature is accepted.
Signature
Date

MonthDayYear
Date
Should be Empty:

Reid Early Learning Center 2026-2027 Interest Form

Personal Information

Demographic Information

Language Survey