Please return this form:   By Mail or                          Berlin Community School


                                             Hand Deliver to:               Child Study Team Office


                                                                                        215 S. Franklin Avenue


                                                                                        Berlin, NJ 08009



    Please return by:  2/22/2021


    Parent/Guardian Name _________________________________________________


                Child’s Name___________________________________________________


                Gender  ____ Male   ____ Female                 Birth Date___________________




                Phone Number___________________



    I am/We are interested in enrolling my/our child in the Berlin Borough School District preschool program for the 2021-2022 school year.  I/We understand that this will be a half day program, and it will be in session 5 days a week with the exception of one day per month closing for trainings and workshops.  There will be NO COST for the program and NO TRANSPORTATION will be provided.  Participants will be chosen by lottery.  Your child must be age 4 by October 1, 2021.


     *** Parents - If you are so lucky as to have twins or siblings who will be applying together, please kindly let us know and/or staple their acceptance forms together, as we will consider them as a unit.***


    _________________________          _____________          _________________________

    Parent/Guardian Signature                 Date                            Parent/Guardian Signature



     * Participants in this program will be determined by a lottery drawing in February 2021.  This is NOT the CER preschool program.  Please see the preschool program letter for more details.