District 622 Preschool Catalog 2018-2019 Preschool Catalog | Page 9

Online registration available at www.isd622.org/preschool
2018-2019 Registration Form
After completing this registration you will receive enrollment forms.
Your child will not be placed into a class until the entire enrollment
packet including immunizations and birth certificate are received.
For office use only
Date Registration Received:
□ Male □ Female
Child’s Full Name:
Birthdate:
Home Phone:
Home Address:
City
State
My child has participated in Early Childhood Screening:
Zip
□ YES □ NO
Parent 1/Guardian Name: Parent 2/Guardian Name:
Address: Address:
h | w | c
Alternate Phone:
h | w | c
Alternate Phone:
Email Address:
Email Address:
Look up your elementary school attendance
area at www.isd622.org/boundarymap
Where will your child attend kindergarten?
Please list your preference of preschool class by location, morning/afternoon, and days of week:
First Choice: Location: □ Morning
□ Afternoon Days of Week:
Second Choice: Location: □ Morning
□ Afternoon Days of Week:
Third Choice: Location: □ Morning
□ Afternoon Days of Week:
Are you interested in joining the District 622 Early Childhood Advisory Council? □ Yes □ No
A $50 non-refundable registration fee is required with each registration (except for applications for one of the six
elementary schools with free preschool.) The first and last month’s tuition payments are due by September 1, 2018.
Check #:
Please charge $50 to:
□ Visa
□ Mastercard
□ Discover
Card #:
Exp. Date:
CVV:
Signature:
□
Reduced fees may be available to families who qualify. Check here to have a Reduced Fee Application mailed to the child’s home
address listed above. The form is also available online at www.isd622.org/preschool. Children who are 5 years old on or before
September 1, 2018 are not eligible to receive reduced fees due to state guidelines.
Early Childhood & Family Programs | Beaver Lake Center | 1060 Sterling St N, Maplewood, MN 55119 | 651-702-8411
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