Clone of 25-26 TK/Kinder LI Application

26-27 TK/ Kindergarten Language Immersion Program

Please complete and submit this application by December 19, 2025.
Language Immersion Sites: San Juan Elementary, Viejo Elementary*, Las Palmas Elementary, RH Dana Elementary, Marian Bergeson Elementary*

*Viejo and Marian Bergeson Elementary TK are full day programs
Click here to determine your assigned school of residency.

Please only submit one application per student.
Email*
Notification letter will be sent to email provided above.
Application Code *
Application will be voided if code is invalid
Mandatory Language Immersion meeting attended at*
Date of meeting attended*

MonthDayYear
Date

What grade are you submitting your application for?*

Transitional Kindergarten (TK) -4th birthday before September 1, 2026Kindergarten (K)- 5 years old by September 1, 2026
Application for:*
**Viejo and Bergeson Elementary are full day TK
If you do not get into the school for which you applied, would you like to be considered for placement at an alternate Language Immersion school?

YesNo
If you marked YES above, please select second school option

Student Name

First NameLast Name
Student Birthdate

MonthDayYear
Date
Is your child a current TK student at the same language immersion school that you are applying to?*

YesNo
Parent/Guardian Name

First NameLast Name
Contact Phone Number
Please enter a valid phone number.
Home Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Is the student a child of an employee of CUSD?

YesNo
If you marked YES above, provide employee's full name and work location/site?
Do you currently have another child in our Language Immersion Program?

YesNo
If you marked YES above, provide student's full name and school site
What is your preferred language of communication/correspondence?

EnglishSpanishOther
Other

My child resides

Within the CUSD attendance boundaries for the Language Immersion schoolWithin a different CUSD school’s attendance boundaryOutside of the CUSD attendance boundaries
Name of School of Residency
If you answered OTHER, please indicate the Name of the School

Please Note

*If you live within the attendance area of the immersion school to which you applied, you will need to provide a recent electric, gas or water/sewer bill, or a rent or mortgage statement that clearly indicates your current address. The school must be able to verify your home address to complete registration. Please bring verification with the application.

** If you reside outside of the CUSD attendance boundaries, you will be required to submit an interdistrict transfer form approved by the public school district of your residency. This is not needed for the application, but will be requested during the registration process.
Signature

Clear
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26-27 TK/ Kindergarten Language Immersion Program