Editing previous response:

Please fix the highlighted areas below before submitting.

2022-2023 EUSD Preschool Eligibility Form and Application

Please be sure to complete the Exeter Unified School District Preschool Application. This can be found in English and in Spanish.

Both forms can be uploaded to this page via the Upload box, below.

Eligibility List for Exeter Unified Preschool.

Please complete the form below. Required fields marked with an asterisk *

Child's Name*

Answer Required

Date of Birth*

Answer Required

Parent/Guardian 1- Name*

Answer Required

Relationship*

Answer Required

Parent/Guardian 1- Phone Number*

Number Required

Parent/Guardian 1- Email Address*

Answer Required

Gross Monthly Income (Before taxes). Include child support, cash aid, and any other income received.*

Answer Required

Parent/Guardian 2- Name

Answer Required

Relationship

Answer Required

Parent/Guardian 2- Phone Number

Number Required

Parent/Guardian 2- Email Address

Answer Required

Gross Monthly Income (Before taxes). Include child support, cash aid, and any other income received.

Answer Required

Number of other children in the family under age 18*

Answer Required

Total family size*

Answer Required

Total Family Income*

Answer Required

Please select:

Answer Required

I am a single parent/guardian

I am a state-certified caregiver and can provide proof

Referred by CSP

Referred by "other"

Parent/Child's Home Address

Street Address

Answer Required

City

Answer Required

Zip/Postal

Answer Required

Upload Completed Exeter Unified School District Preschool Application

Answer Required

Choose a file or drag it here.

English and Spanish Preschool Applications can be found in fillable PDFs, here.

I am requesting preschool services for the child listed above. In order to remain on the waiting list, I understand that it is my responsibility to update this information at least once every six (6) months or as changes occur. I understand that enrollment at this location is based on space availability, enrollment priority, and priority rank. When notified that space is available, I understand that EUSD preschool staff will verify all information on this form to make sure my child is eligible before he/she can be enrolled.*

Answer Required

I agree

I do NOT agree

To verify and determine eligibility for subsidized child care services, you must bring the following documentation to your certification appointment:

ELIGIBILITY VERIFICATION – Documentation must be provided for 1 or more of these categories:

Child Protective Services (CPS) or At-Risk Referral Letter
Self-Declaration of Homelessness or Homeless Referral Letter
Current Aid Recipient Verification (Example: Notice of Action or Passport for Services)
Guardian: Documentation of any income received for the child
Income Verification
Authorization to Release Employment Information (if applicable)
Income documentation from all sources
- Predictable Income: Gross income for the month preceding
- Unpredictable Income: Gross income for the preceding 3 to 12 months
- If employment is seasonal, agricultural, includes bonuses or commission provide past 12 consecutive months of income

FAMILY SIZE VERIFICATION – At least 1 of the following documents must be provided for ALL children counted in the family size:

Birth Certificate
Passport for Services from the county welfare department
Adoption documents Records of Foster Care placement
Court orders regarding child custody or guardianship

RESIDENCY VERIFICATION – Proof that you live in the State of California, Exeter Unified School District.

Any evidence of your street address dated within the past 30 days

OTHER DOCUMENTATION – The following documents are also required:

Child’s immunization record for each child being enrolled
Infant & Family Service Plan (IFSP) or Individual Education Plan (IEP) (If applicable)
Court orders if they affect your child care days/hours (If applicable)

NOTE: We will not schedule you for an appointment until the application is COMPLETE.

IF YOU HAVE ANY QUESTIONS, PLEASE CONTACT PRESCHOOL OFFICE AT (559) 592-2141 EXT 3024

Confirmation Email

Confirmation Email *

Email Required