NEW 3-Year-Old UPK

3-Year-Old UPK

2026–27
Please select the 3-year-old program you are applying for:
Student Information
Student's name

First NameMiddle InitialLast Name
Student's date of birth

MonthDayYear
Age student will be on Dec. 1, 2026
Student must be 3 by Dec. 1, 2026 and must not turn 4 before Dec. 1, 2026.
Student's gender
Student's preferred language

Other
Other language(s) the student speaks
Student's primary address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Has the student ever lived anywhere else?
Student's previous address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Has the student ever attended a childcare or preschool program?

Parent/Guardian Information
- Parent/Guardian's name
  
  First NameLast Name
- Parent/Guardian's relationship to student
- Parent/Guardian's date of birth
  
  MonthDayYear
- Does the Parent/Guardian live at the student's primary address?
- Parent/Guardian's address
  
  Street Address
  
  Street Address Line 2
  
  CityState / Province
  
  Postal / Zip CodeCountry
- Parent/Guardian's cell phone
  Please enter a valid phone number.Format: (000) 000-0000.
- Parent/Guardian's alternate phone
  Please enter a valid phone number.Format: (000) 000-0000.
- Parent/Guardian's email
  example@example.com
- A valid cell phone number and email address are necessary for full functionality of ParentSquare, our school-to-family messenger app. If you do not provide this information, you may miss important messages from the school.
  
  Many companies (Google, Yahoo, etc.) provide email addresses free of charge.
- Parent/Guardian's employer
- Parent/Guardian's work phone
  Please enter a valid phone number.Format: (000) 000-0000.
- Parent/Guardian's preferred language
  
  Other
- Other language(s) the Parent/Guardian speaks

Foster and Kinship Care
Is the student in foster care or kinship care?
Guardian's relationship to student
Date guardianship was established

MonthDayYear

Household Information

List any additional persons living with the student

Rows	Name	Gender	Age	Relationship to student
Additional Person 1
Additional Person 2
Additional Person 3
Additional Person 4
Additional Person 5
Additional Person 6
Additional Person 7

Medical Providers
Does the student have a Primary Care Physician?
- Primary Care Physician's name
  
  First NameLast Name
- Primary Care Physician's phone
  Please enter a valid phone number.Format: (000) 000-0000.
- Does the student have a Dental Provider?
- Dental Provider's name
  
  First NameLast Name
- Dental Provider's phone
  Please enter a valid phone number.Format: (000) 000-0000.

Transportation
Yes, I acknowledge there is no transportation, and I will be responsible for arranging transportation to and from the UPK site.

Site
Transportation is not provided.

All programs run Monday–Friday, three hours per day, and align with the school district calendar. Participation will be determined by a lottery drawing and is subject to the program receiving New York State funding. While there is no guarantee that each child will receive a UPK spot, when an application is selected, every attempt is made to place your child.

Please contact the site for specific hours or to schedule a tour.

Half-Day Site

Happiness House - (315) 789-6850
Transportation is not provided.

All programs run Monday–Friday, six hours per day, and align with the school district calendar. Participation will be determined by a lottery drawing and is subject to the program receiving New York State funding. While there is no guarantee that each child will receive a UPK spot, when an application is selected, every attempt is made to place your child with the first choice indicated.

Please contact the site for specific hours or to schedule a tour.

Full-Day Site

District-Operated UPK at North Street School — (315) 781-4104

Supporting Documents

All applications must include acceptable proof of age and proof of residency, proof of a physical and immunizations, and, if applicable, custody orders or proof of guardianship. (Students who are protected under the McKinney-Vento Act are entitled to immediate enrollment in school even if they don’t have the documents normally needed.)
You may upload the supporting documents here, drop them off at North Street School, or mail them to:

Geneva CSD Head Start/UPK

Attn: UPK

400 West North St.

Geneva, NY 14456
Proof of age

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Proof of residency

Cancelof
Proof of physical

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Proof of immunizations

Cancelof
Custody papers or proof of guardianship (if applicable)

Cancelof

Additional Records Requests
I consent to the release all health and dental records to the Geneva City School District for the purpose of registering of the above student.
Parent/Guardian's signature

Clear
Today's date

MonthDayYear
Should be Empty: