<p> For Office Use Only Supply Fee  Birth Certificate  Shot Record  Number </p><p>SANTA FE R-X 2017-18 PRESCHOOL APPLICATION</p><p>This application is to be completed by parents of potential preschool students at Santa Fe R-X Elementary. Please return this form to the school office with the $20 supply fee (non-refundable), immunization record and a copy of the student’s birth certificate.</p><p>Student’s Age before August 1, 2017 ____ BIRTHDATE: ______</p><p>Student Name Last First Middle</p><p>Race (You may select more than one) American Indian/Alaska Native Black/African American Asian Native Hawaiian or Pacific Islander Hispanic White</p><p>Student Social Security Number - - Gender:  Male  Female</p><p>Parent/Guardian Name </p><p>Home Address (street and P.O.) </p><p>City County </p><p>Home Phone Cell Phone </p><p>______</p><p>Email Address </p><p>Please list others living in the home </p><p>Mother’s Employer Phone </p><p>Father’s Employer Phone </p><p>Day Care Provider Phone </p><p>In the event of an early dismissal due to weather, my child’s plan for going home will be the following unless I call the school: </p><p>The preschool application will only be accepted with the $20 supply fee (non-refundable), the student’s immunization record and a copy of the student’s birth certificate. 2017-2018 Preschool Information (Keep this page for your information)</p><p>THE MISSION OF SANTA FE ELEMENTARY SCHOOL</p><p>The Mission of the Santa Fe R-X Elementary School is to provide an educational environment for children of the district which will foster their intellectual, physical, social, and career development in a caring and nurturing environment. Information for 4-year-old students:</p><p> Students must be 4 years old before August 1, 2017.  The 4-year-old class will meet every day Monday thru Friday during the school hours of 8:00-3:05.  Pre-School will follow the Santa Fe R-X School calendar.  Weekly fees for 4-year-old students will be $80 per student, or payments may be amended based on free or reduced lunch qualifications.  Tuition is due on the first school day of each month.</p><p>Information for 3-year-old students:</p><p> Students must be 3 years old before August 1, 2017.  The 3-year-old class will meet on three full days each week on Mondays, Wednesdays and Thursdays during school hours from 8:00-3:05.  Pre-School will follow the Santa Fe R-X School calendar.  Weekly fees for 3-year-old students will be $48 per student, or payments may be amended based on free or reduced lunch qualifications.  Tuition is due on the first school day of each month.</p><p>Priority for preschool enrollments will be given to 1) 4-year-olds living in the Santa Fe School District (and staff member’s children attending the Santa Fe School District) 2) 3-year-olds living in the Santa Fe School District 3) 4-year-olds living outside of the Santa Fe School District 4) 3-year-olds living outside of the Santa Fe School District</p><p>More information is available in the Santa Fe R-X Preschool Handbook which can be found on our website at www. santafechiefs.k12.mo.us . </p>