Application

PLEASE NOTE: THE APPLICATION PROCESS FOR THE 2017-2018 SCHOOL YEAR IS NOW CLOSED. IF YOU WISH TO BE CONSIDERED FOR THE WAITING POOL, YOU MAY SUBMIT AN APPLICATION AND THE ACCOMPANYING FEE.

Solicitud en Español

Child’s Information

Child’s First Name*

Child’s Last Name*

Child’s Birth Date*

Child must be born on or before March 3, 2016 to be eligible for the 2018-19 school year. We are presently accepting applications for the 2018-19 school year. If you wouuld like to be considered for the 2017-2018 school year waiting pool, please email admissions@missionkidsco-op.org after submitting your application.

 

Child’s Sex* 

Ethnicity – Child* 

Primary Language – Child* 

Secondary Language – Child 

Street Address

City

State/Province

Zip

Country


Parent/Guardian 1

First Name – Parent 1*

Last Name – Parent 1*

Ethnicity – Parent 1* 

Primary Language – Parent 1* 

Secondary Language – Parent 1 

Occupation

Special Skills/Expertise

Phone Number*

Email


Parent/Guardian 2

First Name – Parent 2

Last Name – Parent 2

Ethnicity – Parent 2 

Primary Language – Parent 2 

Secondary Language – Parent 2 

Occupation

Special Skills/Expertise

Phone Number

Email


Availability

How many days per week would you like your child to attend?* 

Preferred Days (please use Ctrl, Alt or Command key to select multiple days)* 

Please list family members who would serve as Parent Teachers*

 Are you interested in the option to buy out of shift requirements?

 Are you interested in working extra shifts in exchange for dues reduction?

 If you are low income, would your family be interested in applying for a scholarship?

Volunteer Interests (please use Ctrl, Alt or Command key to select multiple interests)* 

Preferred Shifts (please use Ctrl, Alt or Command key to select multiple shifts)* 


Child/Family Info

Names and ages of siblings

Why would your child and family be a good fit for the co-op?

Please describe how your family can contribute to our school’s diversity

Summarize your child’s previous experiences with preschool or childcare

How did you hear about Mission Kids?

Family Income Limits
Family of: 1 person 2 people 3 people 4 people 5 people 6 people 7 people 8 people
Extremely Low Income $23,750 $27,150 $30,550 $33,950 $36,650 $39,400 $42,100 $44,800
Low Income $39,600 $45,250 $50,900 $56,550 $61,050 $65,600 $70,100 $74,650
Moderate Income $79,500 $79,500 $89,448 $99,396 $107,352 $115,296 $123,240 $131,196
Above Moderate Income 1 $131,197 $131,197 $131,197 $131,197 $131,197 $131,197 $131,197 $131,197
Above Moderate Income 2 $200,000 $200,000 $200,000 $200,000 $200,000 $200,000 $200,000 $200,000
Above Moderate Income 3 >$200,000 >$200,000 >$200,000 >$200,000 >$200,000 >$200,000 >$200,000 >$200,000

Please reference the grid to indicate your family income level* 

Additional comments or clarifications:

By submitting this application, I affirm that the facts set forth in it are true and complete.

I understand that if my child is accepted at Mission Kids Co-op, any false statements, omissions, or other misrepresentations made by me on this application may result in our family’s immediate dismissal.*

After submitting this application, you should receive a confirmation email within 2 days. If you do not, please contact us at admissions@missionkidsco-op.org. Thank you!