2018-2019 App...

2018-2019 Application Information


2018-2019 Application Form

Thank you for your interest in CCNS! Please complete the form below if you are applying for the 2018-2019 school year.

2018-2019 Class Schedule

Class Age* Frequency Days Time Price
* Children seeking enrollment in a 2’s class must be that age on or before September 1 of the admission year. DO NOT SEND THIS APPLICATION FOR A CHILD WITH A BIRTHDATE AFTER SEPTEMBER 1, 2018. They will not be able to attend school this academic year and a NONREFUNDABLE application fee is required. Please contact the director with questions.
**If you are enrolling after December 1st, please contact our director at director@ccnsslc.com to see if there is a current opening.
Voyagers 2-year-old 2 days/wk T TH 9 – 11:30 AM $160/month
Explorers 2-year-old 2 days/wk T TH 9 – 11:30 AM $160/month
Trailblazers 2/3 year-old mixed 3 days/wk M W F 9 – 11:30 AM $195/month
Investigators 4-year-old 4 days/wk M T W TH 12 – 2:30 PM $225/month
Adventurers 3-year-old 3 days/wk M W F 9 – 11:30 AM $195/month
Pathfinders 3/4-year-old mixed 3 days/wk M W TH 12 – 2:30 PM $195/month

Please choose your first-choice class for the 2018-2019 school year.

In the space above, please list in order of preference, the other classes you would consider for your child if you are unable to enroll in your first-choice class.

Child Information

Does your child have any allergies?

List the allergies your child has.

List any medications your child takes on a regular basis.

Parent Information

Fill out Parent 1 with the primary residence of the child.

Parent 1

Parent 2

Do both parents share a primary address?

Emergency Contact Information

If a parent cannot be reached these people may be contacted in case of an emergency.

Contact 1

Put same phone number if only one phone number to contact

Contact 2

Put same phone number if only one phone number to contact

Child Pick Up Information

People listed here will be allowed to pick up your child in the absence of a parent.

Pickup 1

Pickup 2

Pickup 3

Pediatrician / Family Physician Information

More About Your Child

Fill out the following to help us understand more about your child and how to better communicate with and teach them.

Does your child have any physical limitations in activities or other issues relating to health?

Describe, in detail, any physical or health related issue(s) or limitation(s) your child has.

Describe any previous group experience your child has had.

Describe any word peculiarities your child uses that might help us understand them more easily. For example, words for toilet, etc.

Describe any special interests or abilities of your child.

More About Your Primary Residence

List languages (other than English) that are spoken in the child’s home.

List any adults (other than the parents) living in the child’s home.

List any pets the child has at home.

Other Children in the Family

Sibling 1

Has this child attended CCNS?

Sibling 2

Has this child attended CCNS?

Sibling 3

Has this child attended CCNS?

About You

Let us know more about yourself so we can get to know you better!

What was your reason for enrolling your child in CCNS? What would you and your child like to gain from this experience?

How did you hear about our school?

Parent Background

By signing below, I acknowledge that I have never been accused or convicted of a crime or felony other than a minor infraction or moving violation.

I acknowledge that I have never been accused or convicted of a crime or felony other than a minor infraction or moving violation.

By signing below, I acknowledge that CCNS reserves the right to conduct a background check at any time.

I acknowledge that CCNS has the right to perform a background check at any time.

Parent Agreement

As a member of our community, parents share responsibility for the organization and operation of the preschool. At least one parent from each family is required to do the following.

Assist in class during the scheduled co-oping times, at least twice a month. If there is a scheduling conflict, you must find a replacement, let the teacher know, and note the change on the co-op calendar.

Provide snack (drink on field trips) as scheduled for each co-oping session. Provide accurate attendance with checking in/out if scheduled as attendance parent.

Participate in one parent committee to aid in the operation of the school. A fee of $300 will be levied for non-participation.

Attend MANDATORY general meetings twice a year, in August and February.

Attend parent-teacher conference meetings twice a year.

Attend food handler’s training (this is provided by the school at the first general meeting and by email later in the year).

Pay tuition by the first of every month. You will be assessed a $25 late fee on the next Friday and every month thereafter. I acknowledge that if I fail to pay CCNS upon leaving the school, that I will be responsible for additional late, attorney, court, and other possible fees.

Secure your own child’s car seat in the assigned car during field trips. Failure to do so will prevent your child from attending the field trip.

Arrive at school on time for drop-off and pick-up each day. Frequent tardiness is very disruptive for everyone.

Please sign below to indicate you have read and understand the Parent Agreement. Failure to uphold your family’s commitment to the community may result in termination of your child’s placement at the school.

Parent Code of Conduct

Diversity is embraced here. CCNS does not allow discrimination against any child, parent or employee because of race, gender, cultural identification, sexual orientation, religious affiliation, or socio-economic status.
CCNS emphasizes a philosophy of social readiness and community-building during the formative years of young childhood. Adhering to the CCNS code of conduct promotes quality early childhood development which is dependent upon team work, communication, and a collaborative work environment. Every year, we pledge ourselves to offering the students at CCNS opportunities for growth through diversity, creativity, exploration and education.

I commit to demonstrate sensitivity to diverse backgrounds (e.g., gender, race, age, disability, nationality, sexual orientation, religion, etc).
Communication is crucial. CCNS maintains open communication between teachers, administrators, parents, and children. Disruptive and intimidating behavior, both verbal or physical, undermine the quality of early childhood development, disturb day to day interpersonal relationships and/or have a negative effect on a student’s or parent’s feeling of safety in the environment.

I commit to resolve disputes as they arise with respect for all parties, and will report concerns, adverse events, or potential safety hazards as required by CCNS policy.

I commit to be respectful and maintain privacy and confidentiality of all students and parents.

I commit to avoid engaging in disruptive, intimidating, inappropriate or unacceptable behaviors.
Participation is mandatory. CCNS cannot succeed without parent involvement.

I commit to contribute to the school by being a responsible co-oper, by attending required meetings and training sessions, and by participating actively on a parent committee.
Tardiness is impolite and disruptive.

I understand that frequent and disruptive tardiness at pick-up and drop-off times negatively impacts the learning experience for everyone and will strive to be on time.
General rules of conduct

Be kind. All physical contact must be kind, positive, respectful, and appropriate.

Be healthy. I will uphold CCNS’s standards for safe food preparation as mandated by the board of health, and will provide healthy, well-balanced peanut- and nut-free snacks and beverages.

Be safe. Our children’s safety comes first. As a field trip driver, I will refrain from using cell phones (except in the case of an emergency), will obey all traffic laws, will carry the emergency contact sheets for the class on each field trip, and will only drive if I am mentally and physically capable of providing safe transportation for our children.
CCNS requires the full commitment of all community members to make the co-op community work.

As a CCNS parent, I pledge to be a positive example to my child of how to be a good community member and friend. I will strive to be a responsible co-oper, an involved and caring parent, and an active and respectful member of the CCNS co-op community.

Please sign below to indicate you have read and understand the Parent Code of Conduct.

Field Trips

I give my child permission to accompany his or her class at Community Cooperative Nursery School (“CCNS”) on such field trips as are arranged during the school year. I will be responsible for installing my child’s car seat or booster seat in the car they will be riding in for each field trip. (CCNS requires that all drivers on field trips have a current driver’s license and liability insurance coverage.) If I am not comfortable with this arrangement, I know that I am able to make other arrangements with my child’s teacher.

Field Trip Drivers

Are you able to be a driver for field trips? If you choose no, you will need to email the director your reason for choosing so at director@ccnsslc.com.

By signing below you agree that you will abide by the above requirements, you commit to provide correct information regarding your driver’s license and auto insurance, and you agree that you understand that in case of an accident, your insurance will cover the cost.

Driver Information

For example, 1716457 UT

Vehicle Information

Please include information only for the vehicle(s) you will be driving ON field trips.

Media Release

Throughout the school year students attend field trips and events along with normal classroom routines that support their education, promote community service and encourage positive behavior. Often photos are taken by parents during class and at these events. These photos may appear in the school monthly newsletter that is available on our website. Your child’s picture may also appear elsewhere on our website, including the main page. Last names will NOT be used to ensure privacy and security. CCNS may also use your child’s picture, video, or likeness to advertise or create materials in order to promote our school. If your child is included in these promotional materials, their first and last names will not be included.

By signing below, you agree that you have been notified of the possibility that your son / daughter, while attending CCNS, may be included in photographs, video, or other media and authorize the use for print in our newsletter, on our website, or in promotional materials for CCNS.

I give permission for my child’s first name, photograph, video, or other media to be used in the CCNS newsletter, printed in promotional materials, and featured on the CCNS website.

Cell Phone Pledge

CCNS emphasizes a philosophy of social readiness and community building through experience-based learning activities and exploration. Interaction and involvement from co-oping parents is crucial for this learning to take place. CCNS does not succeed without parents who are present and responsible co-opers.

Parental Consent, Medical Release, and Indemnity Agreement

Committee Selection

Each family must participate in one parent committee to aid in the operation of the school. Please read through the committee options and select ONLY THREE committees that interest you.
Rank your three committee selections below to indicate your first, second and third choice.


Please indicate below whether or not you would like to receive the CCNS newsletter.

Half Co-op Application

CCNS is a co-op school and requires each family to help in the classroom by co-oping. However, we understand there are families who have multiple obligations elsewhere, unique situations, or have multiple students at our school. For these families we have an option of Half Co-op where parents will co-op half the regularly scheduled time.
If you would like to apply for Half Co-op, please fill out your reason and situation below. We have limited spots per class for half co-op families and the Board of Directors approves each request. Half Co-op is an additional $50/month for tuition.
*Tuition for half co-op in a 2 year old class is $210/month.
*Tuition for half co-op in a 3 year old class is $245/month.
*Tuition for half co-op in a 4 year old class is $275/month.

Submit Application

When you click the Submit button below you will be sent to the PayPal website. (Even if you don’t have a PayPal account you can still pay with a credit card through their site.) The application fee is NON-REFUNDABLE and is required to process your application.
Please be patient after you click the Submit button. It may take a few moments to process your application.

Thank you so much for your interest in enrolling at CCNS!