Welcome to the Lodi Unified State Preschool online Family Pre-application. *Note: Only one application per family is needed. For any additional children needing preschool services, please click 'Add Another Applicant'.
Parent/Guardian
Parent/Guardian #1 Living in the home
First Name (Required)
Middle Name
Last Name (Required)
Suffix
Birthday (Required)
Gender
Female
Male
Email Address (Required)
Confirm Email Address
It appears that you have previously submitted an application. If you wish to apply again, please contact us by phone or in person.
Mobile Phone
Opt In for Text Messages
Yes
No
Home Phone
Work Phone
Ext.
It appears that you have previously submitted an application. If you wish to apply again, please contact us by phone or in person.
English Proficiency
Little
Moderate
None
Proficient
Other Language
Albanian
American Sign Language
Amharic
Arabic
Armenian
Assyrian
Bengali
Bulgarian
Burmese
Cantonese
Cebuano (Visayan)
Chaldean
Chamorro (Guamanian)
Chaozhou (Chaochow)
Croatian
Dutch
English
Farsi (Persian)
French
German
Greek
Gujarati
Hebrew
Hindi
Hmong
Hungarian
Ilocano
Indonesian
Italian
Japanese
Kannada
Kashmiri
Khmer (Cambodian)
Khmu
Kikuyu (Gikuyu)
Korean
Kurdish (Kurdi, Kurmanji)
Lahu
Lao
Mandarin (Putonghua)
Marathi
Marshallese
Mien (Yao)
Mixteco
Native American
Other Non-English Language
Pashto
Pilipino (Tagalog)
Polish
Portuguese
Punjabi
Rumanian
Russian
Samoan
Serbian
Serbo-Croatian - (Bosnian, Croatian, Serbian)
Somali
Spanish
Swedish
Taiwanese
Tamil
Telugu
Thai
Tigrinya
Toishanese
Tongan
Turkish
Ukrainian
Urdu
Uzbek
Vietnamese
Zapoteco
Employment Status
Cash Aid
Child Support
Employed
Family Provides Support
Self Employed/Self Contracted
Social Security or SSI
Unemployed
Child's Relationship
Biological/Adopted/Step
Foster
Grandchild
Other
Other Relative
Custody
Yes
No
Provides Financial Support
Yes
No
Address
Is your family experiencing homelessness?
Yes
No
Living Address (Required)
Address Line 2
City (Required)
State (Required)
ZIP (Required)
Click here
to find a provider in your area.
Mailing Address same as Living Address
Mailing Address
Address Line 2
City
State
ZIP
Additional Parent/Guardian
Complete this section if there is a 2nd parent/guardian living in the home
Is there another parent/guardian in the family?
Yes
No
First Name (Required)
Middle Name
Last Name (Required)
Birthday (Required)
Gender
Female
Male
Email Address
Confirm Email Address
It appears that you have previously submitted an application. If you wish to apply again, please contact us by phone or in person.
Mobile Phone
Opt In for Text Messages
Yes
No
Home Phone
Work Phone
Ext.
It appears that you have previously submitted an application. If you wish to apply again, please contact us by phone or in person.
English Proficiency
Little
Moderate
None
Proficient
Other Language
Albanian
American Sign Language
Amharic
Arabic
Armenian
Assyrian
Bengali
Bulgarian
Burmese
Cantonese
Cebuano (Visayan)
Chaldean
Chamorro (Guamanian)
Chaozhou (Chaochow)
Croatian
Dutch
English
Farsi (Persian)
French
German
Greek
Gujarati
Hebrew
Hindi
Hmong
Hungarian
Ilocano
Indonesian
Italian
Japanese
Kannada
Kashmiri
Khmer (Cambodian)
Khmu
Kikuyu (Gikuyu)
Korean
Kurdish (Kurdi, Kurmanji)
Lahu
Lao
Mandarin (Putonghua)
Marathi
Marshallese
Mien (Yao)
Mixteco
Native American
Other Non-English Language
Pashto
Pilipino (Tagalog)
Polish
Portuguese
Punjabi
Rumanian
Russian
Samoan
Serbian
Serbo-Croatian - (Bosnian, Croatian, Serbian)
Somali
Spanish
Swedish
Taiwanese
Tamil
Telugu
Thai
Tigrinya
Toishanese
Tongan
Turkish
Ukrainian
Urdu
Uzbek
Vietnamese
Zapoteco
Highest Grade Completed
College Graduate
Declined to state/Unknown
Grad School/post grad trng
High School Graduate
Not HS Graduate
Some College
Employment Status
Cash Aid
Child Support
Employed
Family Provides Support
Self Employed/Self Contracted
Social Security or SSI
Unemployed
Child's Relationship
Biological/Adopted/Step
Foster
Grandchild
Other
Other Relative
Custody
Yes
No
Lives with Family
Yes
No
Provides Financial Support
Yes
No
Family Information
Family's gross annual income (before taxes and other deductions). When completing the Number in Family Section, only include parents and children.
Number of Parents/Guardians
One Parent Family
Two Parent Family
Relationship to Participant(s)
Foster parent(s) not including relatives
Grandparent(s)
Other
Parent(s) (e.g. biological, adoptive, stepparents)
Relative(s) other than grandparents
Primary Language at Home
Albanian
American Sign Language
Amharic
Arabic
Armenian
Assyrian
Bengali
Bulgarian
Burmese
Cantonese
Cebuano (Visayan)
Chaldean
Chamorro (Guamanian)
Chaozhou (Chaochow)
Croatian
Dutch
English
Farsi (Persian)
French
German
Greek
Gujarati
Hebrew
Hindi
Hmong
Hungarian
Ilocano
Indonesian
Italian
Japanese
Kannada
Kashmiri
Khmer (Cambodian)
Khmu
Kikuyu (Gikuyu)
Korean
Kurdish (Kurdi, Kurmanji)
Lahu
Lao
Mandarin (Putonghua)
Marathi
Marshallese
Mien (Yao)
Mixteco
Native American
Other Non-English Language
Pashto
Pilipino (Tagalog)
Polish
Portuguese
Punjabi
Rumanian
Russian
Samoan
Serbian
Serbo-Croatian - (Bosnian, Croatian, Serbian)
Somali
Spanish
Swedish
Taiwanese
Tamil
Telugu
Thai
Tigrinya
Toishanese
Tongan
Turkish
Ukrainian
Urdu
Uzbek
Vietnamese
Zapoteco
Number in Family
Gross Annual Income
Is your family receiving cash benefits or other services under the Temporary Assistance for Needy Families (TANF) program?
Yes
No
Is your family receiving Supplemental Security Income (SSI)?
Yes
No
Is your family receiving services under the Supplemental Nutrition Assistance Program (SNAP), formerly referred to as Food Stamps?
Yes
No
Child (Applicant)
Children who turn 4 years old on or before December 1st of the current school year will have priority.
First Name (Required)
Middle Name
Last Name (Required)
Suffix
Birthday (Required)
Gender
Female
Male
Does your child have a disability or do you have any concerns about your child's development?
Yes
No
Is there anything else you want to tell us about your child?
Location Preferences
Which program are you applying for? (Required)
State Preschool 2022-2023
1st Location Preference
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2nd Location Preference
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- Your Address
- Available Locations
Click a location on the map to see more info
Click here
to find a provider in your area.
Additional Applicant
Do you want to apply now for another child in your family?
Add Another Applicant
Siblings
Are there other children in the family?
Add a Sibling
I understand State Preschool is a 3 hours per day program, Monday - Friday. I understand this information is needed to determine my eligibility for preschool services with Lodi USD and to place my child(ren) on the waiting list. I affirm this information is correct and understand falsifying information invalidates my eligibility for services. Please click submit to finalize your Family Pre-applicationApplication.
Required information is missing, see above.