School Readiness Registration Form

WEST HAVEN DEPARTMENT OF EDUCATION

Dear Parent/Guardian:

 

Please be advised that in order to be eligible for the West Haven School Readiness Program, you must:

 

  1. Complete, sign and date the School Readiness Registration Form. Carefully read the bold print directly above your signature.

    Click here to download the form.

En Espanol

  1. As evidence of residency, provide two or more of the most recent documents (no duplicates please):

          a. Court document

          b. Mortgage receipt

          c. Rent receipt or pertinent provision of lease

  d. Utility bill(s): UI, AT&T, RWA, SCG, Comcast, DirecTV, Dish Network, Oil,
  Real Estate Tax Statement

  1. As evidence of income, please provide:

    a. Four (4) current paystubs showing gross income for each parent/guardian in the household. The State of Connecticut requires four (4) paystubs whether you get paid weekly, bi-weekly or monthly; or,

    b. A signed, dated letter from your employer verifying either hours and hourly rate or annual income; or,

    c. Copy of State Assistance Budget Sheet; or,

    d. Copy of most recent Federal Income Tax Return.

  1. Provide a copy of your child’s birth certificate.

 

Please mail the application and required documentation to: School Readiness Office, West Haven Board of Education, P.O. Box 26010, West Haven, CT 06516, or you may fax it to 203-937-4318. Once your application for the School Readiness Program is received, reviewed and deemed complete, you will be notified in writing that your child has been put on the waiting list. Once a spot becomes available for your child you will be contacted, in writing, by the School Readiness Office. If you have any questions or concerns, please call the School Readiness Office at (203) 931-6836.

Regular attendance is expected; if a child has excessive absences they will be withdrawn from the program to allow admittance of another child in need of care. If a parent/guardian/family has an outstanding balance at any state and/or federally funded program in the City of West Haven and refuses to pay the outstanding balance, they will not be eligible for any state and/or federally funded slot until the balance is paid in full. If a state and/or federally funded program within the City of West Haven has a parent who leaves, or is withdrawn, for an outstanding balance, the program must immediately report the information to the School Readiness Office. The School Readiness Office will then notify all state and/or federally funded programs within the City of West Haven of the parent/guardian/family with an outstanding balance.

PLEASE NOTE, THAT UNDER PENALTIES OF PERJURY, ALL QUESTIONS SHALL BE ANSWERED TRUTHFULLY. IF INFORMATION CONCERNING ANY DOCUMENTS INCLUDING, BUT NOT LIMITED TO, RESIDENCY PROVES TO BE INVALID OR FRAUDULENT, YOUR CHILD SHALL BE DISENROLLED AND THE PARENT/GUARDIAN SIGNEE SHALL BE ASSESSED TUITION AND MAY BE PROSECUTED UNDER THE CRIMINAL STATUTES OF THE STATE OF CONNECTICUT. THE BOARD OF EDUCATION SHALL SEEK TO RECOVER SUCH TUITION THROUGH ALL AVAILABLE CIVIL REMEDIES.

Respectfully,
Dr. Stefania Larry
Early Childhood Coordinator/School Readiness Liaison