REGISTRATION FOR PRE-KINDERGARTEN EDUCATION (2017-‘18)
for children ages 3-5 living in the Springfield School District
Today’s date Child’s Town of Residence
Child’s Name: ______Child’s Date of Birth ______Your child must be 3 by September 1, 2017.
Parent/Guardian’s Name
Mailing Address: ____ Physical Address: __
Telephone: (primary) (alternate phone)
This form with a non-certified birth certificate and 2 proofs of residency (lease/mortgage payment and driver’s license or bill) will register your child for publicly funded pre-k. You will also be required to contact the program directly to inquire about enrolling your child. Vermont birth certificates are available at the town office in the town where your child was born or mom resided at time of birth. For out of state births, please contact the town office in the town your child was born. Non-certified copies should cost $2.
Contacts, phone numbers and addresses of our pre-k partners are provided below for your convenience.
1. Dandelion Wishes: Jen Berquist, 885-3118; 73 Olive St. Springfield, VT 05156
2. Little Stars: Staci Otis, 885-3029; 140 Fairground Heights, Springfield. VT 05156
3. Perkinsville Pre-school, Chelsea Chase, 795-0043, 93 Butterfield Hill Rd., Perkinsville, VT 05151
4. Pine Street Preschool: Jodi Farashahi, 885-6669; 107 Park St. Springfield, VT 05156 (office); 15 Pine Street (classrooms)
5. PlayWorks: Katie Fluharty, 886-5242; 6 Main St., N. Springfield, VT 05150
6. Safe N’ Sound: Rachel Hunter, 886-1070; 68 County Rd., N. Springfield, VT 05150
7. Saxtons River Montessori School: Maeve Sabine, 869-3349; PO 98 Saxton’s River, VT 05154
8. Springfield Learning Garden: Laura Scully, 885-5077; 33 Pleasant St., Springfield, VT 05156
9. Squeaky Sneakers: Sara Lovell-Allbee, 885-5541; 365 Summer St., Springfield, VT 05156
10. Suzy’s Little Peanuts Day School I: Suzy Coutermarsh, 885-7899; 132 Chester Rd., Springfield, VT 05156
11. Suzy’s Little Peanuts Day School II: Suzy Coutermarsh, 546-4499; Ascutney, VT
12. World of Discovery III: Corina Wood, 885-8380; 308 S. Street, Springfield, VT 05156
If you are considering another prequalified pre-k program, please contact Gladys at 885-1150.
If your child is already enrolled in a pre-k program, please provide its name______
If not, please name the program(s) you are most interested in______
I understand that by enrolling my child in public pre-k and receiving the public funding, my child will be counted by the school district in which my child resides, and will be considered a student of that school district. Teaching Strategies GOLD assessment, demographic and other information pertinent to kindergarten registration and transition will be shared with the Springfield School District and the VT Agency of Education.
Parent/guardian signature Date
Registration forms with required documents may be returned to any pre-k partner program, any site that provides pre-k registration forms, by mail or email to: Gladys Collins, 10 Hoover St., Springfield, VT 05156,
Phone: 802-885-1150
Email:
FOR OFFICE USE______Birth certificate received ______2 proofs of residency received