Child’s Name: ______

Date of Birth: ______

(Child must be 4 yrs. old by August 31, 2010)

BerkeleyCounty Universal Pre-K Registration

Preferences 2010-2011

Transportation is not a state requirement for Pre-K and is usually not provided. Some collaborative sites may have transportation. Please mark one of the following:

______I can provide transportation. ______I cannot provide transportation

Please mark all sessions that you would accept. If you would accept either session, mark your first choice with (1) and your second choice with (2). Please note that some sites are full day sessions.

______AM (8:30-11:30) ______PM (12:00-3:00) ______FULL DAY

Slots are filled on a first-come, first-served basis when enrollment materials are returned. Please mark the sites you prefer. If your first-choice site is full when your enrollment materials are returned, you will be placed in the next site you selected. Place a number next to the sites you would accept.

(1st, 2nd, 3rd)

The following sites are Half-DayBerkeleyCountySchool locations or partnerships wheretransportation is not provided:

______BackCreekValleyElementary School

______Child at Heart Child Care/Pre-K (Falling Waters; Wrap around care may be available)

______Country Kids Child Care/Pre-K (Gerrardstown; Wrap around care may be available)

______Hedgesville Elementary School

______Opequon Elementary School

______Winchester AvenueElementary School

The following sites are BerkeleyCountySchool locations or partnerships where transportation is not provided. The following sites are Full Day programs and you must be enrolled in the daycare toparticipate.

______Little Eagle Child Care/Pre-K (Martinsburg; Route 9 near IRSCenter)

______Mustard Seed Child Care/Pre-K(Martinsburg; Corner of Queen and Martin Street)

______New Beginning’s Child Care/Pre-K (Inwood; Rt. 51)

______Norborne Child Care/Pre-K (Martinsburg; Corner of King and College Street)

______Step Ahead Child Care/Pre-K (Martinsburg; Stribling Road; Route 9 near Hedgesville)

______Tiny Tots Child Care/Pre-K (Martinsburg; Rt. 11 North)

*The following sites areHalf-DayBerkeleyCountySchool locations for the peer model program wheretransportation may be offered if space is available:

______*Burke Street Elementary School

______*Marlowe Elementary School

______*Pikeside Academic Learning Center

______*Tuscarora Elementary School

______* War Memorial Park

*Peer model program is a program in which typically developing students participate in a smaller classroom setting with special needs students as language and play models. Parent must agree to testing to make sure that the child is at or above developmental level for this program.

During the school term:

If you are interested in the sites for Berkeley County Schools, please return this packet through June 11, 2010 from 8:30-2:30 at the address below:

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Pikeside Academic Learning Center

Preschool Program

3635 Winchester AvenuePhone: 304-267-3555

Martinsburg WV 25405Fax: 304-267-3557

Directions to Pikeside:

From Interstate 81Exit 12 (Winchester Ave): Go East and turn onto Rt. 11 South - Winchester Ave. Go about 2 miles,and the school is on your left just pass the Pikeside Bowling Alley and Motel.

During the summer months:

Please return this packet in person at the summer registration at from 8:30-3:30 on the following dates only:

July 6, 7, 13, 14, 20, 21, 27, 28Auxiliary Meeting Room

August 3,4442 Eagle School Road

MartinsburgWV25404

Directions to Auxiliary Meeting Room:

From Interstate 81 Exit 16 East (North Queen St) Go to the 4th light and turn left onto Eagle School Road. Go about ½ mile and the facility is on your right. Building is on the right after you turn into the parking lot. Phone: 304-267-3064

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The following sites areHalf-Day HeadStart/Pre-K locations where transportation may beavailable:

______BerkeleyHeights (RESA VIII Head Start/Pre-K)

______Pikeside (RESA VIII Head Start /Pre-K)

______Teacher’s Pet (RESA VIII Head Start/Pre-K)

______Teddy Bear (RESA VIII Head Start/Pre-K)

The following sites are Full Day Head Start/Pre-K locations where transportation may be available:

______Teacher’s Pet (RESA VII Head Start/Pre-K)

______Tiny Tots (RESA VII Head Start/Pre-K)

______VACenter (RESA VII Head Start/Pre-K)

During the school term and summer months:

If you are interested in the sites for Head Start/Pre-K listed above, please return this packet to:

RESA VIII Head Start/Pre-K

109 South College StreetPhone: 304-267-3595

MartinsburgWV25401Fax: 304-267-3599

Directions to RESA VIII Head Start;

From Interstate 81 Exit 13: Take exit 13 King Street towards Martinsburg. Go about 2 miles. Make a left onto Maple Avenue. Make a right onto Burke Street. RESA VIII is on the right.

Make sure you have submitted the following with your packet:

_____Pre-Registration Blue Form

_____Registration/Preference Sheet

_____Birth Certificate (State birth certificate required for enrollment)

_____Social Security Number or card

_____Immunization Record

_____Verification of Income (Head Start Only)

_____Physical Form or date of scheduled exam:______(To be completed by physician’s office)

_____Dental Form or date of scheduled exam: ______(To be completed by dentist’s office)

STUDENTS ARE PLACED ON A FIRST - COME, FIRST - SERVED BASIS WHEN ALL OF THE ABOVE INFORMATION IS RECEIVED.