[vc_row][vc_column][vc_column_text]Child’s Full Name*Birthdate* MM slash DD slash YYYY Please choose the class in which you are interestedLittle Saints – 4’s - Meets Monday – Friday - 8:00-3:00Glory Gems – 4’s - Meets Monday – Friday - 8:00-11:30/AMGlory Gems -4’s - Meets Monday - Friday - 12:00-3:00/PMJesus’ Jewels -3’s - Meets Tuesday - Thursday - 8:00-11:00/AMJesus’ Jewels-3’s - Meets Tuesday - Thursday - 12:00-3:00/PMLittle Lambs -2’s - Meets Monday and Friday - 8:00-11:00There is a non-refundable application fee of $150.00 per child due with this application.This fee is only refundable if we do not have an opening for your child. If you are offered a position and choose not to accept the fee will be retained.Priority for preschool enrollment presumes active participation in the St. Aloysius parish; as well as, support of the church and is based on the following:All preschoolers must meet the age requirements of the class for which they are applying.All children must be fully potty trained before entering preschool. With the exception of the Little Lamb’s (two’s).Priority will be given to those students, who are currently enrolled in St. Aloysius Preschool, and the following:Families who are current with tuition, siblings of students currently enrolled in St. Aloysius PreschoolRegistered, active parishioners with children currently enrolled in St. Aloysius Elementary School (K-8th grade).Siblings of students previously enrolled in St. Aloysius Preschool.Registered active parishioners.Non-parishioners.Upon acceptance into the St. Aloysius Catholic Preschool our family will be active participants in supporting the program and staff throughout the school yearName (Printed)Name (Signed)Name (Printed)Name (Signed)Child's Name First Middle Last Name Child PrefersPrimary Address of Child Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Preferred email to use for communication Parents/Guardian NamesMarital Status of ParentsMarriedDivorcedRemarried OtherChild lives withBoth ParentsOne ParentGuardianOtherOtherMother’s NameAddress if different than child Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Home PhoneCell PhoneEmployer/OccupationFather’s NameAddress if different than child Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Home PhoneCell PhoneEmployer/OccupationLegal Guardian’s NameAddress if different Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Child’s Baptismal Date MM slash DD slash YYYY ChurchAre you a member of St. Aloysius Church? Yes NoDate you joined parish MM slash DD slash YYYY Other Children in the FamilyName, age, grade/schoolIs your child POTTY TRAINED? ( MUST be fully trained by school start unless applying for the Little Lamb Program.) Yes NoPlease note status on trainingAre there any known allergies, health, or medical conditions we should be made aware?Has your child had First Steps Interventions? If so, please provide a brief summary of the intervention provided.Is there any specific instructions regarding child’s treatment (allergy medications, ongoing medication, restrictions, behavior patterns)Can your child do these things by him/herself? Wipe after toilet use Blow/wipe nose Manage clothes to go to the bathroom Wash hands properly Eat independentlyDescribe any daycare/preschool experiences your child has had:What are your expectations for the St. Aloysius Preschool Program?UntitledPrinted NameSignatureRelationship to ChildDate MM slash DD slash YYYY Please check how you heard of our program? Friend Brochure Church Bulletin InternetReferred byΔ [/vc_column_text][/vc_column][/vc_row]