FGA Preschool Application Parent/Guardian Information * First Name Last Name Parent/Guardian Phone # * (###) ### #### Parent/Guardian Email * Student Information * First Name Last Name Sex * DOB * MM DD YYYY Ethnicity Which program is your child applying to? * 2 Year Old Pre-K 3 Year Old Pre-K 4 & 5 Year Old Pre-K Free VPK (9am-12pm) Full Time with VPK Program Extended Care Part-Time 2-5 Year old Pre-K (3 Days 9am-12pm) Summer Camp (5-12 Years Old) Name(s) of sibling(s) enrolling in FGA Has the student been approved for a scholarship? * Yes No Pending Not Sure Has the student ever been tested for learning disabilities? * Yes No If yes, please explain: Does the student have an IEP, Psychological Evaluation, 504 Plan or participated in a special Education Program? Does the student have any allergies? * Yes No If yes, please specify: Previous School Contact Information School Name AND Phone Number Church Name of Church where your family attends or is a member of: Photo Release * I give my permission for my child’s photograph to be taken while he/she is in FGA School. Such images may be posted in classrooms, craft projects, presentations or promotional materials, or distributed to staff. I understand that I may terminate this permission at any time in the future. By checking this box I agree to the photo release statement above. Parental Support * The staff desires a harmonious relationship with parents. If parents have a question about a school policy or an event that involves their child, they are to notify their child’s teacher or administrator. An effort will be made to resolve any differences and maintain excellent communication between parents and FGA staff. By checking this box I agree to the parental support statement above. Thank you!