District 622 Preschool Catalog 2019-2020 Preschool Catalog | Page 2

Online registration available at www.isd622.org/preschool
2019-2020 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:
Email Address:
h | w | c
Alternate Phone:
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:

Second Choice: Location:

Third Choice: Location:

□ Morning
□ Afternoon Days of Week:
□ Morning
□ Afternoon Days of Week:
□ 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 Richardson or
Webster) The first and last month’s tuition payments are due by September 1, 2019.
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, 2019 are not eligible to receive reduced fees due to state regulations.
Early Childhood & Family Programs | Beaver Lake Center | 1060 Sterling St N, Maplewood, MN 55119 | 651-702-8411
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