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  • McMinn County Schools Universal PK Application

    The following documents are required unless the enrolling student is in state custody or is experiencing homelessness:

    • Preschool application with proof of income
    • Birth certificate or other official records of birth
    • Current physical examination
    • Two proofs of residency dated within the past two months stating the name of the parent/legal guardian and the address of residence. Acceptable forms of proof of residency include:
      • Option 1: Copy of signed lease agreement or mortgage statement
      • Option 2: Utility bill (i.e., electric, water, gas, or sewer)
      • Option 3: Bank or credit card statement
      • Option 4: Paystub
      • Option 5: Voter Registration or some type of legal mail

    Notes:

    • Completing this application does not qualify your child for the Free or Reduced Meal Program.
    • Submission of this application does not guarantee acceptance into the Voluntary Pre-K (VPK) Program.
    • Refusal to provide income does not prevent provision of special education

  • STUDENT AND HOUSEHOLD INFORMATION

  • Birth Date*
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  • Select all information that applies:
  • Has your child ever attended one of the following? Mark all that apply.
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  • Parent/Guardian #1 Information:

  • Format: (000) 000-0000.
  • Do you live with the student?*

  • Parent/Guardian #2 Information:

  • Do you live with the student?
  • Format: (000) 000-0000.

  • EMERGENCY CONTACT INFORMATION

  • Format: (000) 000-0000.
  • Format: (000) 000-0000.

  • Part A: Family Information

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  • Part B: Program Participation

  • Please select all the programs with which your child, family, or household member participates in currently or during the past school year. Documentation is required upon registration.

  • Part C: Total Household Income

  • Please list ALL INCOME of household family members and how often income is received. Any falsification of information concerning income, residency, birth certificate, and/or completion of this application and other forms may be reason for dismissal.

    Income Instructions: 

    From the list below, please write the Source of Income Code in the space provided to indicate the source(s) of income for each earning individual in the household. Also, please write the Monthly Payment or Wage Amount. Multiply the Payment or Wage Amount by the number of months that you receive the income and then calculate the Amount and the Total Annual income.

    A. Gross Work Income  B. Unemployment  C. Workman's Compensation

    D. Pensions  E. Retirement  F. Social Security Benefits G. Veteran's Benefits

    H.  Child Support  I. SSI Disability  J. Alimony  K. Other (must list)

    *Please enter "NA" in all empty  boxes/cells prior to attempting to submit the form.*

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  • Part D: Income Verification

  • Please check all documents that have been provided as proof of income for all adults in the home.*

  • I certify that the above information in this application is correct. I further understand that any falsification of information concerning income, residence, birth certificate, and/or completion of this application and other forms may be reason for dismissal from Tennessee's Voluntary Pre-K Program.

  • Date
     / /

  • REQUIRED DOCUMENTS

    PLEASE NOTE: THIS APPLICATION CANNOT BE CONSIDERED FOR ENROLLMENT UNTIL ALL REQUIRED DOCUMENTS HAVE BEEN SUBMITTED.
  • Method of Providing Required Documents*
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  • Our PKs are district classrooms located on school sites. Placement is not determined by zoning but prioritizes "at risk" needs, seat availability, and accessibility needs. All VPKs prioritize income eligibility for the first 30 days of the school year. Please mark all MCS PK options for which you would like this application to be considered.*
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