(ssp-00001a) Shining Stars Lottery Application

Lottery Application

Shining Stars PreSchool

2100 Lionel Street NE, Rio Rancho, NM 87144

505-892-7735

Principal: Noelle Caceres

Assistant Principal: Fatima Mendoza

Where all students SHINE!

Click to download Guidelines & Read Before completing application: English

Please Submit ONLY one application per child. Duplicate applications will be removed.

Please double check childs date of birth as dates will be verified. Thank you.

Applications submitted before April 1st 2024 will not be eligible for the next school year (2024-2025).
Please note, if you have completed an application for the 2023-24 school year, you will need to submit an application for the 2024-25 school year (applications do not carry over from year to year).

Date received *

Child's name *

Date of Birth * 🛈 +

Gender *

Child's
age * 🛈

Address *

City *

State * 🛈

Zip *

1st Parent/Guardian's Full Name *

Parent/Guardian's Email *

Parent/Guardian's Phone 1 *

2nd Parent/Guardian's Full Name

Parent/Guardian's Phone 2

Neighborhood Elementary *

Do you have another
child that attends or
is applying for SSPS? *

Other Children's Name(s)

	Child 1	Child 2	Child 3
Full Name	Child 1	Child 2	Child 3

Other Children's Age(s)

	Child 1	Child 2	Child 3
Age	Child 1	Child 2	Child 3

Class
Session
Preference. *

If there are any reasons your child MUST attend an AM or PM session
please explain. This is considered when placing your child.
Session changes are not made during the school year.

Bilingual classrooms at Shining Stars Preschool are intended to enrich and develop the english language while providing Spanish support needed for the student.

Would you like your child
in a bilingual classroom? *

Primary Home Language *

English	Spanish
Other language(s) spoken at the home: Other language(s) spoken at the home:

Has your child been screened
by child find or received special
services in the past or currently? *

No	Yes (when?) Yes (when?)

Does your child currently
receive speech therapy
services at SSPS? *

Family history of any of the following: Please check those that apply. *

Has there been a
separation or divorce? *

No	Yes (when?) Yes (when?)

Do you or your child receive public financial assistance? Please check those that apply:

Please list all adults in the home:

1. Last Name *

1. First Name *

1. Date of Birth * +

1. Last grade completed *

1. Relationship to the child *

1. Place of work *

2. Last Name

2. First Name

2. Date of Birth +

2. Last grade completed

2. Relationship to the child

2. Place of work

3. Last Name

3. First Name

3. Date of Birth +

3. Last grade completed

3. Relationship to the child

3. Place of work

4. Last Name

4. First Name

4. Date of Birth +

4. Last grade completed

4. Relationship to the child

4. Place of work

Please list all children/siblings (other than child applying):

1. Child's Name

1.Lives
at home?

1. Age

1. Grade

1. Relationship 🛈

2. Child's Name

2.Lives
at home?

2. Age

2. Grade

2. Relationship 🛈

3. Child's Name

3.Lives
at home?

3. Age

3. Grade

3. Relationship 🛈

4. Child's Name

4.Lives
at home?

4. Age

4. Grade

4. Relationship 🛈

Early Development:

Was your
child’s birth: *

Full term

Premature

Late

Has your child
had any chronic
or major
health problems? *

Yes

No

If yes, please list chronic or major health problems: *

Is your
child potty
trained? *

Number of times
child has moved
since birth. *

Does your
child currently
attend preschool? *

No	Yes (which one?) Yes (which one?)

Please describe your child (interests, likes, dislikes, strengths, etc.) *

My child is bothered by or struggles with: *

Has your child participated in any other programs? (such as private preschool, dance lessons, sports, daycare, etc.) *

I am worried about: *

Is there anything we didn’t ask that you would like to share?

Lottery Application Requirements: SSPS is currently a half-day program that meets for 4-year-old program students M-F (Wednesday is Whiz Kid Wednesday and all 4y program students come for the morning session regardless of the session my child attends.) I understand no 3y program students attend at all on Wednesdays. This may or may not continue for the 2024-25 school year. *

I understand the Lottery Application Requirements.

Survey: When our 4y student program (ONLY) changes to full day preschool (2025-2026) would you participate? *

Parent Signature *

clear

Parent/Guardian
Signature Date

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webmaster only

Please keep the application guidelines page for your information, and submit this application by Sunday April 14, 2024

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