Early Learning Application 2024-2025

Student Information

Genderrequired

Is your student currently on an IEP?required

Is your child currently enrolled in the 2023-2024 school year in an Andover Early Learning Program?required

Home/Residential Information

Andover is still a closed School District for PreK students, and the Andover Early Learning Program. Non-resident PreK Applications will not be accepted!

Staterequired

Contact Information

Primary Contact

Please list the Primary Contact for your student. This information will be used for updates regarding your Early Learning Application, school related communications, attendance, and any emergencies.

Relationship to Studentrequired

Staterequired

Phone 1 Typerequired

Check if this Parent/Guardian has no email address.

Is any parent/guardian a current employee of the Andover Public School District?

Programs

The following programs are available. Please select “Yes'' in the dropdown below for any of the programs which you would like your student considered. Selection will be based on the students date of birth. Multiple programs can be selected at once. Preferences will be chosen later in the application. All Early Learning Programs are Half-Day Programs with students attending Monday - Thursday, either in the morning, or the afternoon.

3 Year-Old Fee Based Half-Day Pre-K Program

(Birthdates from 09/01/2020 to 08/31/2021)

This program is only available for birth dates between 9/1/2020 - 8/31/2021. Please unselect this program and select one that meets the birthdate criteria.

3 Year-Old State Half-Day Pre-K Program.

(Birthdates from 09/01/2020 to 08/31/2021)

This program is only available for birth dates between 9/1/2020 - 8/31/2021. Please unselect this program and select one that meets the birthdate criteria.

If you would like your student to be considered, check all criteria that apply.

Single Parent Household

Teenage Parent at the Time of Child's Birth

Parent(s) do not hold a High School Diploma or GED

Limited English Proficiency *Eligibility determined by district screening assessment.

(Language other than English is primarily spoken in the home)

Qualify for free lunches on the Federal Lunch Program *Reduced lunch is not a qualifier

(Lunch program application is required. Applications will be available after July 1)

Developmental Delay *Eligibility determined by district screening assessment.

Child is showing lower than expected developmental progress

Department for Children and Families (DCF) referral (ex. foster care)

At least one criteria must be selected.

3 ½ Year-Old and 4 Year-Old Fee Based Half-Day Peer Model Pre-K Program.

(Birthdates from 09/01/2019 to 03/01/2021)

This program is only available for birth dates between 9/1/2019 - 3/1/2021. Please unselect this program and select one that meets the birthdate criteria.

4 Year-Old Fee Based 4 Half-Days Pre-K Program

(Birthdates from 09/01/2019 to 08/31/2020)

This program is only available for birth dates between 9/1/2019 - 8/31/2020. Please unselect this program and select one that meets the birthdate criteria.

4 Year-Old State Half-Day Pre-K Program.

(Birthdates from 09/01/2019 to 08/31/2020)

This program is only available for birth dates between 9/1/2019 - 8/31/2020. Please unselect this program and select one that meets the birthdate criteria.

If you would like your student to be considered, check all criteria that apply.

Single Parent Household

Teenage Parent at the Time of Child's Birth

Parent(s) do not hold a High School Diploma or GED

Limited English Proficiency *Eligibility determined by district screening assessment.

(Language other than English is primarily spoken in the home)

Qualify for free lunches on the Federal Lunch Program *Reduced lunch is not a qualifier

(Lunch program application is required. Applications will be available after July 1)

Developmental Delay *Eligibility determined by district screening assessment.

Child is showing lower than expected developmental progress

Department for Children and Families (DCF) referral (ex. foster care)

At least one criteria must be selected.

4 Year-Old Fee Based All Day Pre-K Program

(All birthdates between 9/1/2015 - 8/31/2016)

This program is only available for birth dates between 9/1/2015 - 8/31/2016. Please unselect this program and select one that meets the birthdate criteria.

5 Year-Old Fee Based Half-Day Pre-K Program.

(All birthdates between 9/1/2018 - 8/31/2019)

This program is only available for birth dates between 9/1/2018 - 8/31/2019. Please unselect this program and select one that meets the birthdate criteria.

At least one program must be selected.

Time Preferencerequired

*Pick a time preference that works for your family. Preference will be considered, but is not guaranteed

Day Preference

4 Half Days; Monday throught Thursday
2 Half-Days; Monday and Wednesday
2 Half Days; Tuesday and Thursday

Which preference is most important to your family?required

*Preference will be considered, but is not guaranteed

Time
Program

Rank the order of program preferences. You must assign a priority to each program below.

You must assign a priority to each of the programs listed below. All priorities must be unique.

One program must have a priority of 1.

3 Year-Old Fee Based Half-Day Pre-K Programrequired

3 Year-Old State Half-Day Pre-K Program.required

3 ½ Year-Old and 4 Year-Old Fee Based Half-Day Peer Model Pre-K Program.required

4 Year-Old Fee Based 4 Half-Days Pre-K Programrequired

4 Year-Old Fee Based All Day Pre-K Programrequired

4 Year-Old State Half-Day Pre-K Program.required

5 Year-Old Fee Based Half-Day Pre-K Program.required

Upload Documents

If you are unable to upload documents at this time, you can bring them to Cynthia Diller at Prairie Creek Elementary, during the office hours of 8:00 a.m. - 4:30 p.m., when school is in session. You can also email them to dillerc@usd385.org as a picture or a scan. Documents must be received no later than February 2, 2024!

State Certified Birth Certificate

Upload a copy of a state certified birth certificate. Hospital certificates will not be accepted.

Birth Certificate

Proof of Residency

Upload two forms of Proof of Residency. One must be a copy of a Contract or Rental Agreement, and one must be a copy of a utility bill.

Contract on a house or lease agreement

Utility Statement (gas, electric, or water)

Check this box if you are residing with another resident in Andover, and will not have proof of residency in your own name.

Electronic Signature

The electronic signature below, and all of its related fields, replaces a handwritten signature on paper and is legally binding.

I affirm that the information provided is true, correct and complete, to the best of my knowledge and belief. This electronic signature below and its related fields are treated by like a handwritten signature on a paper form.

Parent/Guardian Signature

I Agreerequired

You may only select today's date

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