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Child’s Information

Child’s Birth Date*

Child must be born on or before August 27, 2018 to be eligible for the 2020-21 school year. We are presently accepting applications for the 2020-21 school year. The deadline for 2020-21 applications is February 14, 2020. If you would like to be considered for the 2019-2020 school year waiting pool, please email after submitting your application.

Child’s Gender* 

Prefer to self describe Gender

Ethnicity – Child*

Primary Language – Child*

Secondary Langauge – Child

Parent/Guardian 1

First Name – Parent 1*

Last Name – Parent 1*

Ethnicity – Parent 1*

Primary Language – Parent 1*

Secondary Language – Parent 1


Special Skills/Expertise

Phone Number*

Parent/Guardian 2

First Name – Parent 2

Last Name – Parent 2

Ethnicity – Parent 2

Primary Language – Parent 2

Secondary Language – Parent 2


Special Skills/Expertise

Phone Number



How many days per week would you like your child to attend?*

Preferred Days (please use Ctrl, Alt or Command key to select multiple days)*

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

Names and ages of siblings.

Why would your child and family be a good fit for the co-op?

Please describe how your family can contribute to our school’s diversity.

Summarize your child’s previous experiences with preschool or childcare.

How did you hear about Mission Kids?

Family Income Limits
Family of: 1 person 2 people 3 people 4 people 5 people 6 people 7 people 8 people
Extremely Low Income $33,850 $38,700 $43,350 $48,350 $52,250 $56,100 $60,000 $63,850
Low Income $64,116 $64,116 $69,624 $80,628 $93,528 $106,428 $108,840 $111,264
Moderate Income $108,348 $108,348 $121,956 $135,456 $146,304 $157,152 $167,952 $178,800
Above Moderate Income 1 $175,000 $175,000 $175,000 $175,000 $175,000 $175,000 $175,000 $180,000
Above Moderate Income 2 $250,000 $250,000 $250,000 $250,000 $250,000 $250,000 $250,000 $250,000
Above Moderate Income 3 >$250,000 >$250,000 >$250,000 >$250,000 >$250,000 >$250,000 >$250,000 >$250,000

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 Thank you!