Early Childhood Academy (Pre-K) Application

Knowledge Quest Early Childhood Academy Application

This application is for Knowledge Quest's full-day preschool program. Please fill out this application carefully and double check to ensure that all information provided is accurate and correct, including spelling.

Registration Date*

Select today's date

Classroom*

Afterschool Care*

Are you enrolling your child in our Extended Learning Academy? (3pm to 6pm)

Eligibility

Will the child be 12 months of age on or before August 15, 2026?*

Will the child be 2 years of age on or before August 15, 2026?*

Will the child be 3 years of age on or before August 15, 2026?*

Will the child be 4 years of age on or before August 15, 2026?*

Uh Oh!

Based on their age, your child is not eligible for the class you've selected until the next school year!

Parent or Guardian Information

Please provide information for the child's primary caregiver.

Guardian Name*

First Last Optional: Sr., Jr., III, etc.

Relationship*

Date of Birth*

Is this person completing the application?*

Yes

No

Yes, with assistance.

If not, who is?

First Last

Guardian Address*

Same as child

Street Address Apartment # City State ZIP Code

Phone Number:*

Email:

Authorized Pick Up?*

Primary Contact?*

Legal Guardian?*

If not, who is the child's Legal Guardian?

First Last

Parent/Guardian Additional Information

Please provide demographic information about the parent/guardian listed above.

Relationship Status*

Education Level:*

Employment Status*

Full-Time

Part-Time

Unemployed

Not working

Employer Name*

Job Title or Position

Work Phone

Work Address (Optional)

Street Address Address Line 2 City State ZIP Code

Add Parent/Guardian?*

Parent/Guardian #2 Information

Optional: contact information for a second parent or guardian.

Parent/Guardian Name*

First Last Optional: Sr., Jr., III, etc.

Relationship*

Date of Birth*

Phone Number:*

Email:

Does this person live with child?*

Address:*

Same as child

Street Address Apartment # City State ZIP Code

Authorized Pick Up?*

Education Level:*

Employment Status*

Full-Time

Part-Time

Unemployed

Not working

Child's Medical Information

The parent/guardian is responsible for providing Knowledge Quest with medical information and specific emergency procedures.

Are there any medical conditions or specifications?

Including allergies, medical issues, food requirements, etc.

Yes

No

If yes, please list conditions/concerns. Add a new row for each.

Does participant have a regular Primary Physician/Pediatrician?*

Yes

Yes, but I cannot provide contact information at this time

No, there is no pediatrician or primary physician

Name

Prefix First Last

Physician Phone*

Insurance Name:

Policy #:

Hospital Affiliation:

Dismissal Information

What is the child's mode of transportation?*

Pick Up by designated party

Released to KQ ELA (Afterschool)

Stay Tuned for More Information

Please look out for communication from our Extended Learning Academy staff regarding program expectations.

Additional Persons Authorized to Pick Up Child

List at least 1 person and up to 3 additional people that are allowed to pick your child up.

Authorized Pick Up Person #1*

First Last Phone Relationship

Authorized Pick Up Person #2

First Last Phone Relationship

Authorized Pick Up Person #3

First Last Phone Relationship

Emergency Contacts

Please provide contact information for at least one additional adult (other than parent/guardians listed above) to contact in case of emergency. You can add up to 2 emergency contacts.

Emergency Contact #1*

First Last Phone Relationship

Emergency Contact #2

First Last Phone Relationship

Consents & Authorization

Please carefully read the statements below.

Knowledge Quest History

Please provide details about the child and the child's family's previous experiences with KQ programming.

Knowledge Quest Member*

Does your family already have a Family Coach through our Family Stability Center?

Who is Your Family Coach?*

This field is hidden when viewing the form

Family Coach Assignment

If your child is enrolled in the Early Childhood Academy, you will be connected to our Family Coaches at the Family Stability Center (FSC). A Family Coach will reach out to you regarding intake paperwork.

Early Childhood Academy (Pre-K) Application

Early Childhood Academy Application

Early Childhood Academy Application 2026-2027

Knowledge Quest Early Childhood Academy Application

Eligibility

Uh Oh!

Child's Information

Parent or Guardian Information

Parent/Guardian Additional Information

Parent/Guardian #2 Information

Child's Medical Information

Dismissal Information

Stay Tuned for More Information

Additional Persons Authorized to Pick Up Child

Emergency Contacts

Consents & Authorization

Knowledge Quest History

Family Coach Assignment

Thank you for being a Knowledge Quest member!

Gaston Park Campus

College Park Campus

Main Campus