Apply to Mission Kids

Child’s Information

Child’s First Name*

Child’s Last Name*

Child’s Birth Date*

Child must be born on or before August 23, 2019 to be eligible for the 2021-22 school year. We are presently accepting applications for the 2021-22 school year. The deadline for 2020-21 applications is February 26, 2021. If you would like to be considered for the 2020-2021 school year waiting pool, please email admissions@missionkidsco-op.org after submitting your application.

Child’s Gender*

Prefer to self describe Gender

Ethnicity – Child*

Primary Language – Child*

Secondary Langauge – Child

Street Address

City

State/Province

Zip

Country

Parent/Guardian 1

First Name – Parent 1*

Last Name – Parent 1*

Ethnicity – Parent 1*

Primary Language – Parent 1*

Secondary Language – Parent 1

Occupation

Special Skills/Expertise

Phone Number*

Email

Parent/Guardian 2

First Name – Parent 2

Last Name – Parent 2

Ethnicity – Parent 2

Primary Language – Parent 2

Secondary Language – Parent 2

Occupation

Special Skills/Expertise

Phone Number

Email

Availability

Please list family members who would serve as Parent Teachers*

Are you interested in the option to buy out of shift requirements?

Are you interested in working extra shifts in exchange for dues reduction

If you are low income, would your family be interested in applying for a scholarship?

Volunteer Interests (please use Ctrl, Alt or Command key to select multiple interests)*

Preferred Shifts (please use Ctrl, Alt or Command key to select multiple shifts)*

Child/Family Info

Does your child have siblings? What are their name(s) and age(s)?

Do you have child care subsidy voucher? Yes No

If Yes, Please select the type of child care subsidy voucher:

Please familiarize yourself with the requirements of Mission Kids co-op participation. Share a bit about why your family could be a good fit for the work responsibilities in the co-op.

We strive to cultivate a school community that teaches children to value their own lived experience and the lived experiences of others. What about your family’s lived experience are you teaching your child to value and are looking forward to bringing to our community?

What are you looking for in a preschool experience for your child and your family?

How did you hear about Mission Kids?

Family Income Limits
Family Size	1 person	2 people	3 people	4 people	5 people	6 people	7 people	8 people
Band 1	$33,850	$38,700	$43,350	$48,350	$52,250	$56,100	$60,000	$63,850
Band 2	$56,450	$64,500	$72,550	$80,600	$87,050	$93,500	$99,950	$106,400
Band 3	$90,450	$103,350	$116,250	$129,150	$139,500	$149,850	$160,150	$170,500
Band 4	$112,752	$112,752	$126,852	$140,904	$152,196	$163,452	$174,756	$186,000
Band 5	$175,000	$175,000	$175,000	$175,000	$175,000	$175,000	$200,000	$200,000
Band 6	>$250,000	>$250,000	>$250,000	>$250,000	>$250,000	>$250,000	>$250,000	>$250,000
Band 7	>$350,000	>$350,000	>$350,000	>$350,000	>$350,000	>$350,000	>$350,000	>$350,000

Please reference the grid to indicate your family income level*

Additional comments or clarifications:

By submitting this application, I affirm that the facts set forth in it are true and complete.

I understand that if my child is accepted at Mission Kids Co-op, any false statements, omissions, or other misrepresentations made by me on this application may result in our family’s immediate dismissal.*

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After submitting this application, you should receive a confirmation email within 2 days. If you do not, please contact us at admissions@missionkidsco-op.org. Thank you!