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2024-2025 Preschool Peer Models Classroom Application
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Name of preschool child (first, middle, last) *
Child's date of birth *
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Child's gender *
Street Address, city, state, zip *
Parents' Full Names *
Primary Email Address *
Primary Phone number *
Languages spoken in the home *
Names and ages of siblings who are currently enrolled at Kaechele Elementary *
Why are you interested in having your child attend this preschool program? *
Why do you think your child would make a good role model for this program? *
Has your child ever attended a preschool or daycare program before, and if so, how many hours per week? *
Please give an example of how your child communicates with other children in social settings (birthdays, playgroups, etc). *
Has your child received early intervention services in the past due to any kind of developmental delay?  If so, please describe. *
Is your child potty trained? *
Do adults who are unfamiliar with your child have difficulty understanding your child's speech? *
Does your child need help with self care skills such as eating, washing hands, taking off coat/hat? *
Does your child have any food allergies or medical needs you would like us to know about? *
Please use this space to give any additional details about or any other information you want us to know about your child. *
Please type your full name here to serve as your signature on this document. *
Thank you for your interest in our program!  Ms. Penny or Ms. Brittany will be in contact with you to discuss your application and answer any questions you might have.
** We reserve the right to dismiss any peer model who is not able to act as a model student within the program.  Parents must be able to provide on-time transportation to and from school each day for their child**
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