Infant, Toddler and Preschool Online Eligibility Form
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  • Infant, Toddler and Preschool Online Eligibility Form

  • Please complete this eligibility form for San Juan Unified School District's Early Childhood Education programs.


    Access the Infant, Toddler and Preschool Programs Map to view all of our program locations.

    • This form must be submitted by a parent or legal guardian.
    • Complete one form for each child.
    • A staff member will get back to you within seven working days if there are any issues with your submission.
    • You must meet all requirements in order to qualify for our programs.
      • Be age eligible
        • Infant and Toddlers: eligible up until their third birthday.
        • Preschool: eligible on their third birthday up to 5 years of age (before Sept. 1).
      • Live within the San Juan Unified boundaries
      • Be income eligible

    For more information on requirements, visit: sanjuan.edu/academics/early-childhood-education/enrollment

  • How did you first hear about our program? (Select all that apply)*
  • What is your child's gender?*
  • Program*
  • Does your student have an Individualized Educational Plan (IEP) or Individual Family Service Plan (IFSP) for Special Education?*
  • Does your child have any serious health conditions, life threatening allergies, or require medication at school that we should be aware of?*

  • Toddler (Center-Based)

  • Select your preferred toddler school location.

    Access the Infant, Toddler and Preschool Programs Map to view all of our program locations.

  • Toddler School Preference*

  • Preschool (Center-Based)

  • Select your preferred preschool location.


    Access the Infant, Toddler and Preschool Programs Map to view all of our program locations.

  • Preschool Preference*

  • Family Data

  • Do you have a copy of a bill/lease/rental agreement with your name on it? It is okay if you do not have one. You may be eligible for other programs.*
  • Format: (000) 000-0000.
  • Can we send text messages to your primary phone number?*

  • How many people live in your household?

    Include:
    Parent(s) or guardian(s)
    Children under age 18 who are related by birth, marriage, or adoption
    A child’s authorized caregiver or legally responsible adult


    (Do NOT include other adults such as roommates, grandparents, or extended family unless they are the legal guardian).

  • How many people live in your household?*
  • Family member #1 date of birth*
     / /
  • Family member #2 date of birth*
     / /
  • Family member #3 date of birth*
     / /
  • Family member #4 date of birth*
     / /
  • Family member #5 date of birth*
     / /
  • Family member #6 date of birth*
     / /
  • Family member #7 date of birth*
     - -
  • Family member #8 date of birth*
     - -
  • Family member #9 date of birth*
     / /
  • Family member #10 date of birth*
     - -
  • Family member #11 date of birth
     / /
  • Family member #12 date of birth
     - -
  • Family member #13 date of birth
     / /
  • Family member #14 date of birth
     / /
  • Family member #15 date of birth
     / /
  • What is/are your sources of household MONTHLY gross income (before taxes)?*
  • Does a household member currently receive CalFresh/SNAP benefits?*
  • What is your family's home language?*
  • Do you need an interpreter?*
  • Should be Empty: