Waitlist Application

2023-24 CHERRY PRESCHOOL WAITLIST APPLICATION

"*" indicates required fields

Warren W. Cherry Preschool is an independent, parent-governed, not-for-profit, non-sectarian preschool open to all children in our community. The school admits students of any race, color and national or ethnic origin, and does not discriminate in the administration of its educational policies, admission policies, financial aid program, or other school administered programs.

Child's Name*

First Last

Child's Birthdate*

Month

Day

Year

Child's Gender*

Address*

Street Address Address Line 2 City State ZIP Code

Primary Phone*

Parent/Guardian 1 Name*

First Last

Parent/Guardian 1 Email*

Enter Email Confirm Email

Parent/Guardian 1 Work Phone

Parent/Guardian 1 Cell Phone*

Parent/Guardian 2 Name

First Last

Parent/Guardian 2 Email

Enter Email Confirm Email

Parent/Guardian 2 Work Phone

Parent/Guardian 2 Cell Phone

NEW STUDENT QUESTIONAIRRE

Please mark all that apply to your child.*

This will be my child's first school or camp experience.

My child was previously enrolled in another school.

My child has previously attended a program without a parent/caregiver.

Cherry Preschool's Inclusion Program provides in-classroom support for children with disabilities and/or developmental delays. Under the supervision of our Inclusion Director, Inclusion Aides support students with disabilities and/or developmental delays through individual learning goals, special accommodations, and modifications. In order to ensure appropriate social-emotional and academic support for your child, please answer the following.

Inclusion 1*

Does your child currently receive any early intervention support or services (e.g., speech therapy, physical therapy, developmental therapy)?

Yes

Please explain the support or services your child is currently receiving*

Inclusion 2*

Has your child previously participated in any early intervention support or services (e.g., speech therapy, physical therapy, developmental therapy)?

Yes

Please explain the support or services your child received and when.*

Inclusion 3*

Does your child have a current IEP?

Yes

2023 - 24 SCHOOL YEAR WAITLIST

First Choice*

Second Choice

Third Choice

If you are placed in a 4 AM Program would you like to add a 5th day?*

Would you like to add a 4th day?

Please write a note in the box below if there are any special circumstances you want the staff to consider in placing your child.

POLICIES & AGREEMENTS

IMMUNIZATION POLICY

Following the guidelines set forth by the American Academy of Pediatrics and the requirements set forth by the Illinois Department of Public Health and the Illinois Department of Children and Family Services, Warren W. Cherry Preschool requires all enrolled children to be fully vaccinated in order to attend our preschool. If your child is on a delayed vaccination schedule, we will require a letter from your child’s doctor stating and approving the delayed schedule.

PARENTAL PARTICIPATION POLICY

In the spirit of building and strengthening our Cherry community and contributing to Cherry's mission of being a parent governed school we ask that all families be willing to volunteer or make a donation in lieu of donating their time.

REGISTRATION AGREEMENT

I understand that if my child is offered and accepts placement for 2023-24 , a $100 non-refundable Registration Fee will be accessed.

In consideration of holding a class placement for the enrolled child, I accept the obligation to pay the fees in advance for the full academic year, regardless of attendance due to illness or vacation, beginning May 1 (or the first month of placement thereafter), subject to the " POLICY ON WITHDRAWING FROM PRESCHOOL" which can be found on page 30 of the Parent Handbook.

Agree*

Check here to agree

Signature*

FINANCIAL ASSISTANCE

An important part of Cherry Preschool's Community Outreach Program is our effort to make the preschool accessible to all families regardless of their ability to pay. Cherry Preschool does everything in its power to support its families and keep in school all children who are part of the preschool community. Each year, through its budgeting process, the Cherry Preschool board determines an amount of money to be allocated for financial assistance. These funds are for the nine-month school year, Summer Camp assistance is not included. Applications for financial assistance must be completed at the same time as the application for classes. Please review our "FINANCIAL ASSISTANCE GUIDELINES."

Financial Assistance Application?*

Will you require financial assistance to attend Cherry Preschool?

Yes

Household

What is your ANNUAL HOUSEHOLD INCOME from all sources?*

How much does your budget allow you to PAY EACH MONTH for preschool?*

Every family must pay some tuition, according to its means. Awards are limited by the total of available funds. You may not receive the amount you request.

How many people in your household?*

Please include all dependents.

Household members*

Please list all siblings with their dates of birth and the names of adult dependents with the amount of support provided.

Parent/Guardian #1

Information must be provided for both parents, regardless of living situation or marital status.

Parent/Guardian #1*

First Last

Financial Responsibility*

This adult has legal responsibility for this child, supporting the child in part or claiming as a dependent.

Yes

Residence*

This adult lives with this child:

Full time

Part Time

Employer*

Please enter the name of your employer:

Employer's Address and Phone number*

Position Held*

Length of Employment*

Gross Annual Salary (before taxes)*

Parent/Guardian #2

Parent/Guardian #2*

First Last

Financial Responsibility*

This adult has legal responsibility for this child, supporting the child in part or claiming as a dependent.

Yes

Residence*

This adult lives with this child:

Full time

Part Time

Employer*

Please enter the name of your employer:

Employer's Address and Phone number*

Position Held*

Length of Employment*

Gross Annual Salary (before taxes)*

Other Sources of Household Income:

Amount of support

Amount per year from grandparents or other family members:

Number

Amount of other scholarship or fellowship for either parent:

Number

Amount per year of current loans/credit lines, including education loans for current students:

Number

Amount of other financial assistance for children:

Number

Amount of any other income:

Sources of Support

Please describe the sources of the support above.

Extraordinary Expenses or Other Hardships

Please describe below any any additional circumstances you would like us to consider, i.e. outstanding loans or debts, medical expenses, recent loss of employment or expected loss of income:

Documentation

Please attach to this application, pages 1-2 of your most recent federal tax return or, if unavailable, recent pay stubs. If unemployed, please submit a copy of your public aid card (AllKids card is not sufficient). If you are unable to provide this documentation, please contact the office to arrange alternative confirmation.

File*

Drop files here or

Accepted file types: jpg, gif, png, pdf, Max. file size: 64 MB.

Certification

Signature*

I certify that all of the above information is correct. I understand that the school's financial assistance fund is limited by the school's budget and ability to raise funding. I also agree that if my circumstances change, I will notify the school and adjust the amount of financial assistance I am receiving.