EED PreK Application

San Francisco Unified School District
PreK Application
Welcome and thank you for your interest in the Early Education programs at San Francisco Unified School District
(SFUSD). Within this packet you will find information about our PreK offerings and application. If you have any
questions about the application or enrollment process, please contact the Early Education Enrollment Office at one of
our two locations or by email at [email protected].
555 Franklin Street, Room 104
San Francisco, CA 94102
Tel.415.750.8500
OR
1551 Newcomb Avenue
San Francisco, CA 94124
Tel.415.401.2500
OPTIONS
SFUSD currently offers the following PreK options:
 Part-Time / School Term PreK (less than 4hrs/day)
 School Day / School Term PreK (6hrs/day)
 Full-Time / Full Year PreK (more than 6hrs/day)
School Term matches the SFUSD school calendar. Full Year is available July 1st – June 30th.
AGE REQUIREMENTS
To be age eligible for PreK, children must turn 3-years-old prior to September 1st of the year they wish to enroll. Some
SFUSD sites serve only 4-year-old. For these sites children must turn 4 before September 1st of the year they wish to
enroll.
SERVICE CRITERIA
On the following pages you will see listed all the SFUSD sites that offer PreK, the hours of operation, and service criteria.
The service criteria determine a family’s eligibility for enrollment.
For the part-time and school day locations the service criteria are based on family size and income.
Enrollment at full-time / year round sites requires families to be both income eligible and show an additional need (i.e.
seeking employment, attending school, homeless/seeking permanent housing, medically incapacitated, and/or receiving
Child Protective Services.)
Families that do not meet these service criteria can apply for our tuition-based sites.
APPLY
To apply for PreK, please complete the attached application and return it to one of our Early Education Enrollment
Offices (location provided above) or to any of the sites listed on the School Choices page. Once your application is
reviewed and accepted, you will be placed on a citywide eligibility list (for subsidized services) or a waiting list (for
tuition-based services). You will be contacted by an enrollment representative (either from SFUSD or our partner,
Children’s Council/SF3C) when there are possible openings in a school of your choice.
Please Note: Although we will do our best to accommodate your child, completing an application does not guarantee
enrollment.
7/1/2014
555 Franklin Street Room 104
San Francisco, CA 94102
Tel.415.750.8500 ● Fax 415.355-7703
1551 Newcomb Avenue
San Francisco, CA 94124
Tel.415.401.2500● Fax 415.920.5101
School Choices
School
Name
Neighborhood
Raphael Weill
Dr. William
Cobb
SF Public
Montessori
School
Anza Vista/Pacific
Heights/Western
Addition
Bret Harte
Hours of
Operation
Address
Zip
Phone
Age
Range
Service
Subsidized
Service
Criteria
7:30 – 5:30
1501 O'Farrell St
94115
749-3548
3-4
Full-time
(Full Year)
Income+ Need
Requirements
8:40-2:40
2725 California St
94115
749-3436
4
School Day
(School Term)
Income
Requirements
7:45 – 5:45
2340 Jackson St
94115
749-3544
3-4
Full-time
(Full Year)
Income+ Need
Requirements
7:45 – 5:45
950 Hollister Ave
94124
330-1545
3-4
Full-time
(Full Year)
Income+ Need
Requirements
School Day
(School Term)
Full-time
(Full Year)
Income
Requirements
Income+ Need
Requirements
School Day
(School Term)
Full-time
(Full Year)
Income
Requirements
Income+ Need
Requirements
7:50 – 1:50
Dr. Charles
Drew
4
50 Pomona St
Bayview/Hunter's
Point
Leola M.
Havard
94124
330-1546
7:30 – 5:30
8:30 – 2:30
3-4
4
Accept
Tuition
Based**
Yes
Spanish
1551 Newcomb
Ave
94124
8:00 – 2:40
350 Harbor Road
94124
695-5950
4
School Day
(School Term)
Income
Requirements
7:45 – 5:45
1 Trenton St
94108
291-7932
3-4
Full-time
(Full Year)
Income+ Need
Requirements
8:20-11:40 or
12:00-3:00
954 Washington St
94108
291-7921
4
Part-time
(School Term)
Income
Requirements
7:30 – 5:30
990 Church St
94114
695-5871
3-4
Full-time
(Full Year)
Income+ Need
Requirements
Sanchez
Corona
Heights/Noe
Valley/Castro
8:00 – 3:00
325 Sanchez St
94114
241-6380
4
School Day
(School Term)
Income
Requirements
Tule Elk Park
Cow Hollow/Marina
7:30 – 5:30
2110 Greenwich St
94123
749-3551
3-4
Full-time
(Full Year)
Income+ Need
Requirements
Yes
7:45 – 5:45
165 Grattan St
94117
759-2850
3-4
Full-time
(Full Year)
Income+ Need
Requirements
Yes
8:40-2:55
380 Webster St
94117
241-6335
4
School Day
(School Term)
Income
Requirements
7:30 – 5:30
859 Prague St
94112
469-4753
3-4
Full-time
(Full Year)
Income+ Need
Requirements
7:45 – 5:45
300 Seneca Ave
94112
469-4756
3-4
Full-time
(Full Year)
Income+ Need
Requirements
8:00 – 1:50
431 Capitol Ave
94112
469-4089
4
School Day
(School Term)
Income
Requirements
Bryant
7:30 – 5:30
2641 25th St
94110
695-5784
3-4
Full-time
(Full Year)
Income+ Need
Requirements
JuniperoAnnex Serra
7:30 – 5:30
155 Appleton St
94110
920-5138
3-4
Full-time
(Full Year)
Income+ Need
Requirements
7:30 – 5:30
801 Treat Ave
94110
695-5746
3-4
Full-time
(Full Year)
Income+ Need
Requirements
7:30 – 5:30
421 Bartlett St
94110
695-5844
3-4
Full-time
(Full Year)
Income+ Need
Requirements
Cesar Chavez
8:00-11:00 or
11:30-2:30
825 Shotwell St
94110
695-5765
4
Part-time
(School Term)
Income
Requirements
Paul Revere
8:00-11:30
555 Tompkins Ave
94110
695-5656
4
Part-time
(School Term)
Income
Requirements
8:40 – 2:40
45 Cleveland St
94103
615-8450
4
School Day
(School Term)
Income
Requirements
7:45 – 5:45
Malcolm X
Commodore
Stockton
Chinatown
Gordon J. Lau
Theresa S.
Mahler
Grattan
John Muir
Excelsior @
Guadalupe
San Miguel
Sheridan
Las Americas
Zaida T.
Rodriguez
Bessie
Carmichael
Duboce
Triangle/HaightAshbury
Ingleside/Excelsior/
Ocean
View/Merced
Height/Ingleside
Mission/Bernal
Heights
Mission/South of
Market
695-5660
3-4
Immersion
/Dual
Language
Cantonese
Yes
Spanish
Cantonese
Yes
Spanish
555 Franklin Street Room 104
San Francisco, CA 94102
Tel.415.750.8500 ● Fax 415.355-7703
School
Name
John McLaren
E.R Taylor
Neighborhood
Portola/Visitación
Valley
1551 Newcomb Avenue
San Francisco, CA 94124
Tel.415.401.2500● Fax 415.920.5101
Hours of
Operation
Address
Zip
Phone
Age
Range
Service
Subsidized
Service
Criteria
7:30 – 5:30
2055 Sunnydale Ave
94134
469-4519
3-4
Full-time
(Full Year)
Income+ Need
Requirements
8:15-11:15 or
11:45-2:45
423 Borrows St
94134
330-1530
4
Part-time
(School Term)
Income
Requirements
Income+ Need
Requirements
Yes
Yes
Presidio
Presidio
7:45 – 5:45
387 Moraga Ave
94129
561-5822
0-4
Full-time
(Full Year)
Argonne
Richmond/Presidio
Heights/Laurel
Heights
7:30 – 5:30
750 16th Avenue
94118
750-8617
3-4
Full-time
(Full Year)
Income+ Need
Requirements
8:00 – 5:30
1350-25th Ave
94122
759-2852
4
Full-time
(School Term)
Income+ Need
Requirements
8:00 – 6:00
1775-44th Ave
94122
759-2853
3-4
Full-time &
Part-Time
(Full Year)
Income+ Need
Requirements
Jefferson*
Sunset
Noriega
Tenderloin
Tenderloin
8:40 – 2:40
627 Turk St
94102
614-3000
4
School Day
(School Term)
Income
Requirements
Rooftop
7:50 – 1:50
443 Burnett St
94131
695-5691
4
School Day
(School Term)
Income
Requirements
Fairmount
Twin Peaks/Glen
Park/Diamond
Heights
8:30 – 2:30
65 Chenery St
94131
695-5669
4
School Day
(School Term)
Income
Requirements
Starr King
Potrero Hill
8:00 – 2:40
1215 Carolina St
94107
695-5797
4
School Day
(School Term)
Income
Requirements
Accept
Tuition
Based**
Immersion
/Dual
Language
Cantonese
Yes
Cantonese
Yes
Spanish
*This school is available for full time services from August 18, 2014 to June 30, 2015
**Sites indicating they accept tuition have allocated tuition spots, all other sites will only add tuition students if no subsidized students are waiting to enroll.
555 Franklin Street Room 104
San Francisco, CA 94102
Tel.415.750.8500 ● Fax 415.355-7703
1551 Newcomb Avenue
San Francisco, CA 94124
Tel.415.401.2500● Fax 415.920.5101
APPLICATION FOR SUBSIDIZED PRESCHOOL IN SFUSD
1.
Child Information (For all children applying for preschool):
Student #1 Name:
Date of Birth:
Gender:
M
F
Gender:
M
F
Student #2 Name:
Date of Birth:
2.
Parent/Guardian Information:
Single Parent ?
Yes
Teen Parent?
Yes
Family Size (please count only immediate family members)? ___________
If you are a single parent applying for subsidized service, you will be required to provide proof that you are the
only parent/ guardian in the home.
Relationship to Child:
Parent A Name:
Parent
Guardian
Foster Parent
Other:_______________________________
Parent B
Name:
Grandparent
Home Address:
City, State:
ZIP Code:
Primary Phone #:
Alternative
Phone #:
Email Address:
Secondary Contact:
Relationship to Child:
Social/ Case Worker
Friend/ Relative
Employer
School/ Training
Other:______________
Name:
Home Address:
City, State:
ZIP Code:
Primary Phone #:
Alternative
Phone #:
555 Franklin Street Room 104
San Francisco, CA 94102
Tel.415.750.8500 ● Fax 415.355-7703
1551 Newcomb Avenue
San Francisco, CA 94124
Tel.415.401.2500● Fax 415.920.5101
Monthly income for each parent:
If you are applying for subsidized service, you will be required to provide proof of income at the time of enrollment.
Parent/Guardian A
Gross Employment Earnings
Federal or State Cash Assistance
Child Support
Housing Allowances
Unemployment/Disability
Other: ______________________
Parent/Guardian B
$
per month
$
per month
$
per month
$
per month
$
per month
$
per month
$
per month
$
per month
$
per month
$
per month
$
per month
$
per month
Identify the areas of need for child-care below for each parent:
For subsidized service, you will be required to provide proof of need at the time of enrollment.
Parent/Guardian A
Parent/Guardian B
Employed
Seeking Employment
School/Training
Incapacitated
Seeking Permanent Housing
Please check if you are participating in CalWorks activities.
What language would you prefer for future documentation?
Race/Ethnicity (Select one or more):
Hispanic or Latino
English
Spanish
American Indian or Alaska Native
Native Hawaiian or other Pacific Islander
Please check any/all that apply to your family:
Chinese
Asian
Black or African American
White or Caucasian
Child Protective Service
Other: _________________
Other: _________________
At Risk of Abuse
CPS/ At Risk Letter Date:____________________________________________
Foster Child:
Yes
No
Has your child ever been assessed for an IEP? ________
If yes, please explain:_____________________________________________________________________________________
IEP Date:______________________
3.
Preferred Neighborhood Choices:
4.
Preferred School/ Site Choices:
555 Franklin Street Room 104
San Francisco, CA 94102
Tel.415.750.8500 ● Fax 415.355-7703
5.
1551 Newcomb Avenue
San Francisco, CA 94124
Tel.415.401.2500● Fax 415.920.5101
Child information (for all children)
You will be required to provide birth certificates for all children under the age of 18 at the time of enrollment.
Full Name
Sex (M/F)
Birth Date
Native Language
School Name (if attending school).
CERTIFICATION AND SIGNATURE OF PARENT/GUARDIAN
I declare under penalty of perjury that the above information is true and correct to the best of my knowledge. I will notify the agency immediately if
there is any change in my income, family size, residence, employment, or reason for needing child development services. I understand that the
information about my eligibility may be reviewed by representatives of the State of California, the Federal Government, Independent auditors, or
others as necessary for the administration of the program. I understand that if the agency denies this application for services, I have the right to
appeal. I understand that I must renew my eligibility at least once per year (once every six months for protective services children). I further
understand that if I do not renew my eligibility, I will no longer be eligible for subsidized child care services for my child. I understand that I will
receive a notice of approval or disapproval of my application within 30 days from the date I sign this form. I understand that this certification is not
complete until all documentation is submitted and this form has been reviewed, signed, and dated by an agency representative and signed and dated
by me. I understand that completion of this application does not guarantee services.
Signature:
Date:
555 Franklin Street Room 104
San Francisco, CA 94102
Tel.415.750.8500 ● Fax 415.355-7703
1551 Newcomb Avenue
San Francisco, CA 94124
Tel.415.401.2500● Fax 415.920.5101
APPLICATION FOR TUITION-BASED ENROLLMENT
To apply for tuition based PreK your child needs to be 2 years old.
A non-refundable application fee of $50.00 (Cashier’s Check or Money Order only), payable to the SFUSD Early
Education Department, must be submitted with this application for each child you wish to enroll.
Please choose schools with Tuition Based indicated on the schools list. Other while, We will first fill all available
subsidized vacancies before we allocate tuition-based slots at the schools that doesn’t indicated Tuition Based.
1.
Child Information
Student’s Name:
Date of Birth:
2.
Gender:
M
F
Parent/Guardian Information:
Parent A Name:
Parent B
Name:
Home Address:
City, State:
ZIP Code:
Primary Phone #:
3.
Alternative
Phone #:
Preferred School/ Site Choices:
1.____________________________
2.____________________________
3.____________________________
Does the child have a sibling already enrolled in the Early Education Preschool/ Out of School Time Program? ___________
If yes, Child’s name: ______________________________________
***Presidio families only:
Do parents/ family live or work in the Presidio?
EED Site: _________________________________
Live
Work
Sibling attending Presidio EES
CERTIFICATION AND SIGNATURE OF PARENT/GUARDIAN
I understand that:






The PreK program operates on a year-round basis Monday – Friday.
Preschool Hours vary by site.
Enrollment preference is given to children attending PreK 5 days a week.
All tuition fees are due and payable in advance.
I agree to give the school one month written notice if I choose to terminate my contract. No refunds will be
provided.
Selection is based on school availability.
Signature:
Date:

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