Preschool Application

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Welcome

Thank you in advance for choosing TCA Preschool for your child to learn and grow!

I am applying for enrollment into the following grade:(Required)

K2

K3

K4 VPK

Preschool applications will not be processed if they are incomplete. All items listed below must be submitted with the application in order for your child to be accepted into our program. No exceptions can be made.

For your convenience, you can save and continue this application at a later time while you work on putting together all of the necessary documentation.

K2/K3 Checklist

Complete Student Information
Complete Family Information
Parental / Guardianship (court forms if applicable)
Tuition Preference
Contract
Original Immunization Form (DH 680)
Original Physical Form (DH 3040)
Copy of Birth Certificate
Financial Agreement Form
$125 Application Fee

K4 VPK Checklist

Complete Student Information
Complete Family Information
Parental / Guardianship (court forms if applicable)
Tuition Preference
VPK Voucher
Contract
Original Immunization Form (DH 680)
Original Physical Form (DH 3040)
Copy of Birth Certificate
Financial Agreement Form
$125 Application Fee

This enrollment application does not automatically mean your child is accepted into our program. We must review the application and make sure all fields are filled in and all required attachments have been submitted along with the application.

Family Information

Parent's Relationship to Each Other:(Required)

(If divorced, a copy of the Divorce Decree noting guardianship, days of visitation, etc, must accompany this form.)

Parent 1 Information

Name(Required)

First Last

Relationship to Child

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Phone(Required)

Email(Required)

Employer

Work Phone

Parent 2 Information

Name(Required)

First Last

Relationship to Child

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Phone(Required)

Email(Required)

Employer

Work Phone

Emergency Pick-Up Persons

List two local persons other than father and mother / legal guardians who will assume responsibility for your child in an emergency if parents cannot be reached.

First Contact

Name(Required)

First Last

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Phone(Required)

Alternate Phone

Second Contact

Name

First Last

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Phone

Alternate Phone

Emergency Medical Information

Doctor Name

First Last

Preferred Hospital

Hospital Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Hospital Phone

Special Instructions

Please list all allergies and exact reaction to allergies if applicable

Any additional medical information?

In addition, the insurance information requested below can provide necessary information for treatment of your child.

Medical Insurance Carrier

Policy #

Insured's Name

First Last

Authorized Pick-Up List

Name(Required)

First Last

Relationship to Child(Required)

Phone(Required)

Name

First Last

Relationship to Child

Phone

Name

First Last

Relationship to Child

Phone

Name

First Last

Relationship to Child

Phone

Name

First Last

Relationship to Child

Phone

Name

First Last

Relationship to Child

Phone

Child Abuse Policy

Parent 1 / Guardian Initials:(Required)

Parent 2 / Guardian Initials:

Late Pick-Up Policy

Parent 1 / Guardian Initials:(Required)

Parent 2 / Guardian Initials:

CAPTCHA

Welcome

K2/K3 Checklist

K4 VPK Checklist

Student Information

Family Information

Parent 1 Information

Parent 2 Information

Emergency Pick-Up Persons

First Contact

Second Contact

Emergency Medical Information

Student Medical History

Authorized Pick-Up List

Child Abuse Policy

Late Pick-Up Policy

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