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San Marcos Child's Name: Sex: Birth date:
Philosophy Sibling's Name: Sex: Birth date:
Do both your children need to be enrolled on the same days and hours? Yes No
Parent's Name: Student I.D.
Address: City: Zip:
Phone Number : (Day) (CELL PHONE)
E-Mail Address: 

Does your child have any disabilities or limitations that require accommodations? Yes No If yes, please explain:     
____________________________________________________________(We ask this for our awareness and to be better able to serve your child and his or her needs)

Is your child potty trained? 

**FOR STUDENTS ONLY WHO WISH TO APPLY FOR FUNDING:   If you need to apply for Student Subsidiary or State Preschool you must provide your gross family income and the number of family members so the application may be given an admission's priority code.    All applications must be coded with an admission's priority code established from the California Department of Education. Your child's application will not be placed on the waiting list unless this information is provided.
How many are in your immediate family? Gross monthly income
Source of Income: Salary AFDC SSI

CHILD SUPPORT

 

 Unemployment
Do you participate in any funding sources that will pay for your childcare? Yes No
If so, please name the source (s) :
Palomar Students in need of Childcare:

Your child's enrollment days and hours will be based on your class schedule which may include study hours and working.  All children must arrive no later than 9 am.  A minimum of 2 days is required.
Staff and Community Parents in need of Childcare:

Please call the Center at (760) 744-1150   ext. 2575 for more information.  Current rate for children under 3 is $60.00 per day.  No half days are available.  Half day and full day enrollment is available for children 3 1/2 - 5 years old.  Half day rate per day is $29.50. Full day rate is $40 per day.  A Non-refundable registration / materials fee of $90.00 is due at time of enrollment. A minimum of 2 days is required.

The State Preschool Program is located at the Escondido Center for free for children who will be eligible for Kindergarten the following year. Parents have to qualify according to the state guidelines.  For example, a family of 4 whose gross (before taxes) monthly income is below $4000 would qualify.  This focus of this program is to provide all 4 year old children with preschool experiences before entering "K".  Children should be 4 years old by Dec. 2.  This program is 3 hours long and enrollment is 5 days per week, Monday through Friday.

Child Care Hours Needed : 

Community Members: Please indicate the desire date of attendance for your child.  

Students & Staff: Please indicate the desire semester of attendance for your child.

SPRING'12  SUMMER '12  FALL'12  SPRING '13SAN MARCOS  18 MONTHS - 5 YEARS OLD 

ESCONDIDO 3 1/2 - 4 YEARS OLD

Please Indicate the Hours needed:

Monday

Tuesday Wednesday  

Thursday Friday     

INCOMPLETE APPLICATIONS WILL NOT BE PROCESSED

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