2021 - 2022 Pre-K/Kindergarten Dual Language Immersion Program Application Please complete all sections of the application and return it via email to
[email protected] as soon as possible and no later than May 30, 2021. Student Information Last Name First Name Middle Name Street Address Apt. # City State Zip Code Birth date Ethnic Identities (month/day/year) ☐ Hispanic or Latino ☐ Not Hispanic or Latino Racial Identities You are not required to answer this question. Student ID# ☐ Black or African American ☐ American Indian/Alaska Native Next Grade (for the 2021-22 school year) ☐ Native Hawaiian or Other Pacific slander ☐ Asian Choose One: ☐ PK ☐ K ☐ 1 ☐ White Language(s) the child communicates in most Please select your child’s zoned school frequently ☐ Palmer Elementary ☐ Saunders Elementary Parent/Guardian Printed Name Phone Number Daytime Phone Number Email Address Important Note: Dual Language Immersion (DLI) Sibling Priority Families and students must have a long-term commitment Siblings are children who have at least one parent in common and live to this program for a child to get the most from this in the same household. PRIORITY for admission to the DLI program will learning experience. It would be detrimental to all parties be given to brothers and sisters of students currently attending the DLI involved in the program for families not to fulfill this program. commitment. If you are strongly considering a move over the next few years, please consider whether this program Current DLI Student Information is appropriate