REGISTRATION DATES AND May , 208

8:30 a. m. – 3:30 pm

REGISTRATION DATES AND TIMES August 3 - 6, 2015 8:30 am – 4:30 pm

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LOCATION: Pre-Kindergarten classes are offered at the following elementary campuses: Bess Race [(817) 297-5080], Dallas Park [(817) 370-5620], Deer Creek [(817) 297-5880], J A Hargrave [(817) 370-5630], Jackie Carden [(817) 370-5600], Meadowcreek [(817) 370-5690], Oakmont [(817) 370-5610], Parkway [(817) 568-5710], Sidney H Poynter [(817) 568-5730], Sycamore [(817) 568-5700]

You may apply for Pre-Kindergarten during registration at your child’s assigned elementary school. Students are assigned to schools based upon residence location within an elementary boundary. To locate the elementary boundary for your child see the Crowley ISD website, www.crowleyisdtx.com.

PRE-KINDERGARTEN ELIGIBILITY REQUIRMENTS:

• Child must be 4 years old on or before September 1st. • Families must meet “one” of the following criteria:

Family income must fall within federal guidelines. Parent/Guardian(s) must show proof of income with the current income tax return or 3 current (May, June, July) paycheck stubs

Limited English Proficiency

Child has ever been in foster care Guardian must provide a copy of the Court Order for State Conservator Letter of Pre-K Eligibility from Texas Department of Family and Protective Services

Homeless (as defined by McKinney-Vento Act) Child of an active duty member of the armed forces, mobilized Reservist or member of the Texas National Guard, including the child of a member who was hurt or killed on active duty.

Parent/Guardian must present a Department of Defense identification (such as a DoD photo Id), or a statement of service, or an official letter from a commander stating that he/she is on active duty or mobilized.

• Must live within the Crowley I. S. D. school zones. • Child must meet immunization requirements by August of this year.

PARENTS MUST BRING THE FOLLOWING ITEMS WITH THEM TO PRE-KINDERGARTEN REGISTRATION

1. Copy of the child’s birth certificate 3. Proof of Eligibility (as listed above) 2. Proof of income 4. Proof of Residence

a. Current Income Tax Return 5. Drivers License of person enrolling student b. 3 paycheck stubs (May, June, July) 6. Immunization Records

The application must be completed during registration at your child’s assigned elementary school.

Children will not be officially enrolled in Pre-Kindergarten until all registration documents have been completed, which includes Residency Verification, Income Verification and Language Proficiency Testing.

Questions? Call your campus registrar.

FECHAS Y HORARIOS DE MATRICULACIÓN

Del 3 al 6 de agosto de 2015 8:30 a.m. – 4:30 p.m.

LUGAR : Las clases de Pre-Kindergarten serán ofrecidas en las siguientes escuelas de primaria: Bess Race [(817) 297-5080], Dallas Park [(817) 370-5620], Deer Creek [(817) 297-5880], J A Hargrave [(817) 370-5630], Jackie Carden [(817) 370-5600], Meadowcreek [(817) 370-5690], Oakmont [(817) 370-5610], Parkway [(817) 568-5710], Sidney H Poynter [(817) 568-5730], Sycamore [(817) 568-5700]

Usted podrá presentar la solicitud de Pre-Kindergarten durante el periodo de matriculación en la escuela de primaria que le corresponda a su hijo(a). Los estudiantes serán asignados a las escuelas de primaria que estén dentro del lindero. Para localizar el lindero de la escuela de primaria de su hijo(a) visite la página Web www.crowleyisdtx.com.

REQUISITOS PARA LA ELECCIÓN DE PRE-KINDERGARTEN:

• El niño(a) deberá haber cumplido los cuatro años de edad para el 1 de septiembre o antes. • Las familias deberán cumplir con “uno” de los siguientes criterios:

Los ingresos de la familia deberán estar dentro de las directrices federales. Los padres/tutores deberán mostrar la prueba de la declaración de la devolución de impuestos sobre los ingresos o 3 recibos actuales del salario (mayo, junio, julio). Si el niño(a) tuviera conocimientos limitados de inglés. Si el niño(a) hubiera estado viviendo temporalmente con padres adoptivos:

Los padres/tutor deberán proporcionar una copia del mandato judicial del tutor “State Conservator”. La carta de selección de los Servicios de Protección de la Familia del Departamento de Texas (Texas Department of Family and Protective Services).

Si el niño(a) estuviera sin hogar (como fue definido por “McKinney-Vento Act”). Si el niño(a) es hijo(a) de un miembro activo de las fuerzas armadas, de la reserva movilizada o miembro de “Texas

National Guard”, incluyendo, si fuera hijo(a) de un miembro que sufrió heridas o falleció, o estuviera en el servicio activo.

Los padres/tutor deberán presentar la identificación del Departamento de Defensa (tal como la tarjeta de identificación con fotografía del Departamento de Defensa), o declaración indicando que está en el servicio, o una carta oficial del comandante indicando que él o ella está en el servicio activo o movilizado.

• Deberá vivir dentro de las zonas de las escuelas del distrito de Crowley I.S.D. • El niño(a) deberá cumplir con los requisitos de vacunación para agosto de este año.

LOS PADRES DEBERÁN TRAER PARA LA MATRICULACIÓN DE PRE-KINDERGARTEN LOS SIGUIENTES DOCUMENTOS:

1. Una copia del certificado de nacimiento del niño(a). 2. La prueba de los ingresos.

a. La declaración actual de la devolución de impuestos sobre los ingresos.

b. Tres recibos del salario (mayo, junio, julio.

3. La prueba de elegibilidad (tal y como fue mencionado en la parte superior).

4. La prueba de la residencia. 5. La licencia de conducir de la persona que esté

matriculando al estudiante. 6. La tarjeta de las vacunas.

La solicitud deberá completarse durante el periodo de matriculación en la escuela de primaria asignada a su hijo(a).

Los niños no estarán oficialmente matriculados en Pre-Kindergarten hasta que todos los documentos hayan sido debidamente cumplimentados, en los cuales se incluirán: la verificación de la residencia, la verificación de los ingresos

y el resultado del examen del nivel del conocimiento del idioma (Language Proficiency Testing). Si tuviera alguna pregunta, por favor, llame por teléfono al “registrar” de su escuela.

Pre-Kindergarten Registration Process

In Texas, public Pre-K is a compensatory program. The program is mandatory only for children that are considered to be “at risk” of not being successful in kindergarten, rather than a universal program open to all four-year-olds. Therefore, children and their parents or legal guardians must meet qualifying criteria set forth by the State of Texas.

SECTION 1 - PRE-KINDERGARTEN ELIGIBILITY REQUIRMENTS:

• Child must be 4 years old on or before September 1 of the school year • Families must meet “one” of the following criteria:

o Be educationally disadvantaged (eligible to participate in the National School Lunch Program [NCLP] or in Head Start) Family income must fall within federal guidelines.

Parent/Guardian(s) must show proof of income with the current income tax return or 3 current paycheck stubs.

If currently in Head Start, the parent or guardian must provide the school district with a copy of a document (signed and dated) from the Head Start Program (HSP) that certifies that the child is currently enrolled as a participant in the HSP. o Limited English Proficiency o Child has ever been in foster care

Guardian must provide a copy of the Court Order for State Conservator, or Letter of Pre-K Eligibility from Texas Department of Family and Protective

Services o Homeless (as defined by McKinney-Vento Act) o Child of an active duty member of the armed forces, mobilized Reservist, or member of

the Texas National Guard, including the child of a member who was hurt or killed on active duty. Parent/Guardian must present a Department of Defense identification (such as a

DoD photo Id), or a statement of service, or an official letter from a commander stating that he/she is on active duty or mobilized. Important: DoD Id card must not be copied.

• Must live within the Crowley I. S. D. • Child must meet immunization requirements by August of school year

Application: The application is designed to gather appropriate information to help determine if the student is eligible for the PK program in CISD. The Campus Principal is responsible for making the determination based upon the application and documents provided by the parent/guardian.

PARENTS MUST BRING THE FOLLOWING ITEMS WITH THEM TO PRE-

KINDERGARTEN REGISTRATION

1. Copy of the child’s birth certificate 2. Proof of income

a. Current Income Tax Return b. Three current paycheck stubs

3. Proof of Eligibility (as listed above) 4. Proof of Residence 5. Driver’s License of person enrolling student

Revised – 5/2012 1

Pre-Kindergarten Registration Process

Revised – 5/2012 2

SECTION 2 – CAMPUS PROCEDURES

1. Parents/guardians will complete all information on the PK application and registration packet. Completed packet contains PK application, Registration Packet and supporting documents. 2. Campus Office Staff

a. Will keep a list of PK applicants b. Will review each application to ensure completely filled-in c. in the “For School Use Only” box

• will write-in the Student’s age AS OF September 1 (not current age, but age of student on the first day of September) using birth certificate

• will write-in the number of people in the household d. Will verify the income information in #6 matches the income documents provided by

parent/guardian • will write-in Total of Monthly Income from total of all rows in #6 • will copy the Income tax form or 3 paycheck stubs and attach to the PK

application form for documentation. For households receiving food stamps or other Temporary Assistance for Needy Families (TANF) benefits, copy the original Notice of Eligibility that indicates the Case # and Case Worker’s contact information.

e. Will view documents presented for active military personnel. If DoD Id is presented do not copy (see SAAH Section 7.2.5.1). Sign full name and date in “For School Use Only” box

f. Will • providing the principal is available to review and approve or deny the

application, have the parents/guardians wait for approval/denial (IF ALL DOCUMENTATION FOR QUALIFICATION IS PROVIDED) OR

• let the parent know to expect notification of approval/denial either by telephone or mail. Note: Homeless must be verified by District liaison before approval can be given.

g. Will copy all required documentation for the student’s cumulative records

3. Campus Principal or professional designee will review the application for approval according to the following information:

a. If #2 Home Language Survey indicates a language other than English on either question, refer the student to the person administering the oral language proficiency testing in August. After testing, circle #2 in the “For School Use Only” box and either 0 or 1 for the LEP indicator.

b. If #3 Foster Care is Yes – the student will be approved for PK, if proper TDFPS documentation is provided. The principal or designee will circle the number #3 in the “For School Use Only” box that indicates the qualifying criteria and Approve or Deny with reason for denial.

c. If #4 Homeless is checked below the top box (living in own home or apt) – the student may be approved for PK after the Residency Questionnaire is

Pre-Kindergarten Registration Process

Revised – 5/2012 3

verified by the District Homeless Liaison. The principal or designee will circle the

number #4 in the “For School Use Only” box that indicates the qualifying criteria. Send a copy of the application to the CISD Homeless Liaison for verification. Parents/guardians cannot be given approval until the district liaison has verified the Residency Questionnaire.

d. If #5 Military Dependent is Yes – the student will be approved for PK, and

the approval letter must be marked for parent/guardian to bring appropriate DOD documentation. (See documentation below) The principal or designee will circle the number #5 in the “For School Use Only” box that indicates the qualifying criteria and Approve or Deny with reason for denial.

e. If none of the first five criteria qualify the student for PK, the student may only

qualify based upon Income #6. The Income Eligibility Guidelines (chart attached) come from the Department of Agriculture and are used to determine if the student is eligible for the National School Lunch Program (for free and reduced price meals). Parent/guardian must complete the application for Free and Reduced Lunch to be sent to Food Services. Paystubs and income tax forms do not need to be sent to Food Services – attach these to the PK application and file in cumulative folder.

Pre-Kindergarten Registration Process

Revised – 5/2012 4

SECTION 3 – DOCUMENTATION REQUIRED AT REGISTRATION

Along with documentation required for completing the Enrollment packet for registering New Students, Pre-Kindergarten registration may require additional documentation as proof of eligibility. The documentation listed below as required for each PK-qualifying category comes from the Student Attendance Accounting Handbook http://www.tea.state.tx.us/index2.aspx?id=7739 or TEA contacts.

• Child’s birth certificate • Child’s immunization records • Child’s social security card • Proof of Residency – current electric, water, or gas bills showing name, current address, and

date (telephone bills are not accepted) • Tx Dept of Family and Protective Services document

o Court Order for State Conservator o Letter of Pre-K Eligibility (sample letter found at the link listed above)

• Dept of Defense ID or Statement of Service • Proof of Income

o Current Year Income Tax form o 3 current (3 previous months) paycheck stub

For students who qualify under:

Foster Care (#3) – According to the Texas Department of Family and Protective Services’ contact for TEA

o If the student is currently in foster care, the case worker may provide the school with a copy of the court order requiring state conservatorship.

o If the student was formerly in foster care, the parent has received and should provide the school with the letter from TDFPS that indicates the student is eligible for PK.

Homeless (#4) – No additional documentation. Parents/guardians must complete the entire Enrollment packet. The Residency Questionnaire will be used as the documentation for PK. Must be verified by District Liaison.

Military Dependant (#5) – Military member’s Department of Defense photo ID (Do not copy), or Statement of Service, or letter from commander stating mobilization to active duty. If military member is deceased, copy the DOD death certificate.

Income (#6) – Proof of Income that corresponds to the information on the application including current Income tax form or 3 current paycheck stubs. Paycheck stubs should be no older than 3 months prior to registration. If parent is only paid in cash, an affidavit from the employer is required, signed and dated.

Pre-Kindergarten Registration Process

Revised – 5/2012 5

SECTION 4 - RESOURCES AND FREQUENTLY ASKED QUESTIONS

Student Attendance and Accounting Handbook http://www.tea.state.tx.us/index2.aspx?id=7739 is the source for rules of Pre-Kindergarten program. On the TEA website http://www.tea.state.tx.us/index.aspx go to Index A-Z, click on P and scroll down to Pre-Kindergarten. This will direct you to a page giving information about PK, Kindergarten, Early Childhood Education and frequently asked questions. (Copied below)

Top 10 Frequently Asked Questions on Early Childhood Education:

1. What criteria must a child meet to be eligible for a public prekindergarten program?

To be eligible for enrollment in a prekindergarten class, a child must be at least three years of age and:

• is unable to speak and comprehend the English language; or

• is educationally disadvantaged; or

• is homeless, as defined by 42 U.S.C. Section 1143a, regardless of the residence of the child, of either

parent of the child, or of the child’s guardian or other person having lawful control of the child; or

• is the child of an active duty member of the armed forces of the United States, including the state

military forces or a reserve component of the armed forces, who is ordered to active duty by proper

authority; or

• is the child of a member of the armed forces of the United States, including the state military forces or a

reserve component of the armed forces, who was injured or killed while serving on active duty; or

• is or ever has been in the conservatorship of the Department of Family and Protective Services following

an adversary hearing held as provided by Section 262.201, Family Code.

1a. Why is prekindergarten only available to certain students?

• Eligibility for free public prekindergarten programs is limited by statute. Eligibility for free public

prekindergarten services are governed by the Texas Education Code (TEC). The Texas Legislature

creates and makes changes to that Code. TEC §29.153(b)

2. Are school districts required to offer a prekindergarten program?

• A district shall offer prekindergarten classes if the district identifies 15 or more eligible children who are

at least four years of age by September 1 of the current school year. A school district may offer

prekindergarten classes if the district identifies 15 or more eligible children who are at least three years

of age.

Pre-Kindergarten Registration Process

Revised – 5/2012 6

2a. Are school districts required to serve three year old students who are eligible?

• No. A district may offer prekindergarten classes if the district identifies 15 or more eligible children who

are at least three years of age. A child who is three years old is eligible for prekindergarten only if the

district operates a three-year-old prekindergarten program.

3. Can school districts offer half-day or full-day prekindergarten programs?

• The state funds a half-day prekindergarten program. However, districts may use other federal, state and

local sources, including collaboration with local Head Start or licensed child care agencies to implement a

full-day program or a program with wrap-around services.

4. Can school districts charge tuition for children who qualify to attend prekindergarten?

• Yes. A school district may offer on a tuition basis or use district funds to provide half-day and full-day

prekindergarten classes to ineligible children or to fund an additional half-day for eligible children.

5. Are there TEKS (Texas Essential Knowledge and Skills) for prekindergarten?

• There are no Texas Essential Knowledge and Skills (TEKS) for prekindergarten. However, in an effort to

align the prekindergarten program with the TEKS, prekindergarten curriculum guidelines have been

developed and distributed to school districts. These curriculum guidelines provide challenging but

achievable skills and concepts that three and four year old children are to know and be able to do in

each subject area delineated in the kindergarten TEKS. The guidelines are organized into 10 skill

domains that support integration of curriculum and build connections between and among all disciplines.

Because there is no state required prekindergarten curriculum, use of these guidelines is voluntary.

6. Is prekindergarten included in the review and adoption cycle for textbooks?

• Yes. The State Board of Education shall adopt a review and adoption cycle for textbooks for elementary

grade levels, including prekindergarten and secondary grade levels, for each subject in the required

curriculum under Section 28.002. In November 2010 the State Board of Education adopted instructional

materials for prekindergarten systems. The new list and descriptions of materials may be found at the

first link under the heading Proclamation 2011, Instructional Materials Adopted Under Proclamation

2011.

7. Can a child who is five years of age on September 1 be enrolled in prekindergarten?

• A child who is five years of age on September 1 of the current school year is not eligible for enrollment in

a prekindergarten class.

Pre-Kindergarten Registration Process

Revised – 5/2012 7

8. Are school districts required to serve three year old students who are eligible?

• No. A district may offer prekindergarten classes if the district identifies 15 or more eligible children who

are at least three years of age. A child who is three years old is eligible for prekindergarten only if the

district operates a three-year-old prekindergarten program.

9. Can school districts keep “waiting lists” of eligible children who are not being served?

• No. It is a law that a school district must offer prekindergarten classes if a district identifies 15 or more

children who are eligible and are at least four years of age by September 1 of the current school year. If

the school district is unable to serve all eligible children, a waiver must be obtained for the number of

eligible children not enrolled in the prekindergarten program. Every effort should be made to serve all

eligible children before requesting a waiver.

10. Can school districts obtain a waiver to not offer the prekindergarten program?

• Yes. On application of a district, the commissioner may exempt a district if the district would be required

to construct classroom facilities in order to provide prekindergarten classes.

PRE-KINDERGARTEN APPLICATION

CROWLEY INDEPENDENT SCHOOL DISTRICT 512 PEACH STREET

CROWLEY, TEXAS 76036 817.297.5800 fax 817.297.5805

*The following application must be completed prior to the registration process in August. Registration information will be sent in approval letter.

In Texas, public Pre-K is a compensatory program. The program is mandatory only for children that are considered to be “at risk” of not being successful in kindergarten, rather than a universal program open to all four-year-olds. Therefore, children and their parents or legal guardians must meet qualifying criteria set forth by the State of Texas.

(Please Print)

1 Student Name Date of Birth

Parent Name

Address

Home Phone Number Work Phone Number

2 Home Language Survey

(Oral language proficiency test in August required)

What language is spoken in your home most of the time?

What language does your child speak most of the time?

3 Has child ever been in foster care? No Yes (State Conservator Court Order or Letter of Pre-K Eligibility from TX Dept of Family and Protective

Services required)

If the child is a foster child; list the child’s monthly personal use income. Write “0” if the child has no personal use income $

4 Please check only one box that best describes where the student is presently living:

In my own home or apartment, in Section 8 housing, or in military housing with parent(s), guardian(s), or caregiver(s); if you checked this box, please check one or both of the boxes below, if applicable:

My home has no electricity My home has no running water

In the home of a friend or relative because I lost my housing (examples: fire, flood, lost job, divorce, domestic violence, kicked out by parents, parent in military and was shipped out, parent(s) in jail, etc.)

In a shelter because I do not have permanent housing (examples: living in a family shelter, domestic violence shelter, child ren/youth shelter, FEMA housing)

In transitional housing (housing that is available for a specific length of time only and is partly or completely paid for by a church, a nonprofit organization, or another organization)

In a hotel or motel (examples: because of economic hardship, eviction cannot get deposits for permanent home, flood, fire, hurricane, etc.)

In a tent, car, van, abandoned building, on the streets, at a campground, in the park, or other unsheltered location.

PRE-KINDERGARTEN APPLICATION

CROWLEY INDEPENDENT SCHOOL DISTRICT 512 PEACH STREET

CROWLEY, TEXAS 76036 817.297.5800 fax 817.297.5805

5 Is your child a military dependent? No Yes (Copy of Department of Defense ID or Statement of Service required)

6 List all members (adults and children) of the household who have income or do not have income.

(Current Income Tax return or 3 current paycheck stubs required) Names of household members Gross Monthly Income

(before deductions)

Job 1 Job 2

Monthly Welfare payments, child support, alimony

Monthly Payments from Pensions, retirement, Social Security

Monthly Any other income

$ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $

Total $ $ $ $ $ $

6 a Food Stamp number AFDC/TANF case number

I certify that all of the above is true and correct and that all income is reported. I understand that this information is being given for the receipt of federal funds, that school officials may verify the information on the application; and that deliberate misrepresentation of the information may subject me to prosecution under applicable state and federal laws.

Parent’s signature

1) Verification of Student’s Age Sept 1 2) LEP indicator circle one 0 or 1 3) Verification from TDFPS 4) Residency Questionnaire 5) Verification of Active Military

FOR SCHOOL USE ONLY

Verification of Immunization

6) Verification of National School Lunch & Child Nutrition Program Circle One 01 02 99

Household size

Total Monthly income

Food Stamps_

AFCD/TANF

Approved Denied Reason for denial Date Letter sent

Approved/ Denied by Date

Do not copy DoD Id – viewed by _________________________Date____________

CROWLEY INDEPENDENT SCHOOL DISTRICT 512 PEACH STREET

CROWLEY, TEXAS 76036 817.297.5800 fax 817.297.5805

PRE-KINDERGARTEN APPLICATION SOLICITUD DE PRE-KINDERGARTEN

*La siguiente solicitud deberá ser cumplimentada antes del proceso de matriculación que se llevará a cabo en agosto. La información relativa a la matriculación será enviada junto con la carta de aprobación.

En Texas, Pre-Kindergarten público es un programa compensatorio. El programa es obligatorio solamente para aquellos niños que estén bajo riesgo (at risk) de no pasar Kindergarten. Este programa no está disponible para todos los niños que tengan cuatro años de edad, por lo tanto, para reunir los requisitos adecuados para este programa, los niños y sus padres o tutor legal, deberán cumplir con el criterio establecido por el Estado de Texas.

(Por favor, escriba con letra de imprenta)

1 Nombre del estudiante Fecha de nacimiento

Nombre del padre, madre o tutor

Dirección

Número de teléfono de casa Número de teléfono del trabajo

2 Encuesta relativa al idioma (En agosto se requiere el examen del nivel de conocimiento del idioma (Oral Language Proficiency Test).

¿Qué idioma se habla en su casa la mayoría del tiempo?

¿Qué idioma habla su hijo(a) la mayoría del tiempo?

3 ¿Ha sido su hijo(a) adoptado temporalmente alguna vez (foster care)? No Sí (Se requiere el mandato judicial del “State Conservator” o la carta de selección para Pre-Kindergarten de los Servicios de Protección de la Familia del Departamento de Texas (Texas Department of Family and Protective Services).

Si el niño(a) estuviera viviendo temporalmente con los padres adoptivos; por favor, escriba la cantidad mensual que utiliza personalmente el niño(a). Escriba “0” si el niño(a) no utiliza personalmente ninguna cantidad, dólares.

4 Por favor, haga una marca donde describa mejor el lugar donde está viviendo actualmente el estudiante. En mi casa o apartamento, en una vivienda de la Sección 8, en una vivienda militar con los padres, tutor legal o personas que están

cuidando al estudiante. Si usted marcó esta casilla, por favor, marque una o ambas casillas en la parte inferior, si se aplica. En mi casa no hay electricidad En mi casa no hay agua corriente

En casa de un amigo o de un familiar porque he perdido mi casa (por ejemplo: a causa de un incendio, inundación, pérdida de empleo, divorcio, violencia doméstica, los padres echaron al estudiante de casa, el padre o la madre es militar y fue enviado a otro lugar, el padre o la madre está en la cárcel, etc.)

En un albergue porque no tengo vivienda permanente (por ejemplo: vivo en un albergue para familias, en un albergue donde acogen víctimas de violencia doméstica, en un albergue donde acogen niños o jóvenes, en una vivienda proporcionada por FEMA).

En una vivienda de transición (vivienda provista solamente durante un tiempo específico y parcialmente o en su totalidad está subvencionada por una iglesia o por una organización no lucrativa o cualquier otra organización).

En un hotel o motel (por ejemplo: a causa de dificultad económica, he sido desalojado de mi vivienda y no dispongo de recursos para dar el depósito de una vivienda permanente, o a causa de una inundación, incendio, huracán, etc.).

En una tienda de campaña, coche, furgoneta, edificio abandonado, en la calle, en un campamento, en un parque o cualquier lugar a la intemperie.

CROWLEY INDEPENDENT SCHOOL DISTRICT 512 PEACH STREET

CROWLEY, TEXAS 76036 817.297.5800 fax 817.297.5805

PRE-KINDERGARTEN APPLICATION SOLICITUD DE PRE-KINDERGARTEN

5 ¿Es su hijo(a) un dependiente militar? No Sí (Se requiere una copia de la tarjeta de identificación del Departamento de Defensa o declaración indicando que está en el servicio activo).

6 Haga una lista de todos los miembros (adultos y niños) de la familia que tengan ingresos o de los que no tengan ingresos. (Se requiere la declaración de la devolución de impuestos sobre los ingresos o 3 recibos actuales del salario). Nombres de los Miembros

de la Familia Ingresos Brutos Mensuales (antes de las deducciones)

Empleo 1 Empleo 2

Mensual Pagos de Welfare, manutención por el menor, pensión

Mensual Pagos de pensiones, jubilación, Seguridad Social

Mensual Cualquier otro ingreso

$ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $

Total $ $ $ $ $ $

6 a Nº de Estampilla de Comida (Food Stamp) ________________ Número del caso AFDC/TANF ________________

Yo certifico que todo lo expuesto en la parte superior es cierto y correcto y que todos los ingresos fueron reportados. Yo entiendo que esta información está siendo proporcionada para recibir fondos federales y que los oficiales de la escuela podrían verificar la información provista en la solicitud. Si yo proveyera información falsa podría ser demandado bajo las leyes estatales y federales que se apliquen.

Firma del padre, madre o tutor

---SOLO PARA EL USO DE LA OFICINA--- FOR SCHOOL USE ONLY

1) Verification of Student’s Age Sept 1 2) LEP indicator circle one 0 or 1 3) Verification from TDFPS 4) Residency Questionnaire 5) Verification of Active Military

Verification of Immunization

6) Verification of National School Lunch & Child Nutrition Program Circle One 01 02 99

Household size

Monthly income

Food Stamps_

AFCD/TANF

Approved Denied Reason for denial Date Letter sent

Approved/ Denied by Date

Do not copy DoD Id – viewed by _________________________Date____________