Enrollment Inquiry

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If you are looking for a high-quality preschool program for your child, please complete the following form.

Preschool Enrollment Request

Please complete the following fields about you:
Parent First Name
Parent Last Name
Street Address
City
State
Zip Code
Phone
Email
_____________________________________________________________________________________________
Approx. household income (Adjusted Gross from tax form)

_____________________________________________________________________________________________
How many people reside in your household?

_____________________________________________________________________________________________
Primary language spoken in the home:

_____________________________________________________________________________________________
School district where I reside:

_____________________________________________________________________________________________
Please answer the following about your child:
Child's First name
Child's Last name
Child's DOB
_____________________________________________________________________________________________
The following questions/statements will help us determine what type of preschool program(s) your child is eligible for. Information will be kept confidential. Please select the best response for each of the following items:
_____________________________________________________________________________________________
My child received developmental services from:

_____________________________________________________________________________________________
I am concerned about:
_____________________________________________________________________________________________
We live:
_____________________________________________________________________________________________
We have moved frequently
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I am concerned about the safety of our neighborhood

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A member of my household has a chronic health condition.

_____________________________________________________________________________________________
A member of my household has been a victim of abuse.

_____________________________________________________________________________________________
I am able to access community services/resources.

_____________________________________________________________________________________________
This child has been exposed to toxic substances--pre/post natal.

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Mom has at least a HS diploma or GED.

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Dad has at least a HS diploma or GED

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Parent was a teen at birth of first child.

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Mom is currently unemployed
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Dad is currently unemployed.
_____________________________________________________________________________________________
A parent is absent due to death, divorce, separation, incarceration, or military service.

_____________________________________________________________________________________________
I am interested in:
_____________________________________________________________________________________________
Thanks for submitting your information. You will be contacted by our office within the next three business days.
_____________________________________________________________________________________________

General Ed / Early Childhood

D.A.T.A.

Professional Development

Poverty Reduction Initiative

REMC II and Online Learning Resources

Pupil Accounting

MOISD - 15760 190th Ave | 15760 S. Bronson (GPS location) | Big Rapids, MI 49307 | Phone (231) 796-3543 | Fax (231) 796-3300