2026-2027 New Student Application - Small Steps Nurturing Center

Student Information

When filling out this application, please have on hand a valid form of ID, your child's birth certificate and social security card, income information (pay stubs, SNAP letter, tax return, or employment letter), and proof of residency. If you have any questions about the application, please email Nancy Espinoza at nespinoza@ssnc.org.

Small Steps Location *

Student's Legal Name *

First

Last

Date of Birth *

Gender *

Male
Female

Student's Ethnicity *

Hispanic/Latino
Non-Hispanic/Latino

I want to add a second student to this application.

Student's Home Address *

Address Line 1

Address Line 2

City

State

Zip Code

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Parent or Guardian Information

The child(ren) lives with: *

Mother Only
Father Only
Grandparent(s)
Legal Guardian (A copy of the official guardianship document will be required if accepted)
Other Relative (without legal guardianship)
Caretaker (without legal guardianship)
Other

Guardian 1's Full Name *

First

Last

Guardian's address is same as child(s)? *

Relationship *

Other: *

Guardian's Cell Phone *

Guardian's Email *

Guardian #2's Full Name

First

Last

Father's/ Guardian's address is same as child(s)?

Father's/ Guardian's Cell Phone

Father's/ Guardian's Email

Emergency Contact Name *

Emergency Contact Phone Number *

Emergency Contact Relationship *

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Income Information

Total number of people in household (i.e. anyone who lives in the household) *

Total household income (total amount any adult in home makes) *

Is the total income monthly or annually? *

Referral Information

Have any other family members attended Small Steps?

Yes
No

Has the student(s) ever attended any other daycare or school (Headstart, HISD, private school)? *

Yes
No

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Insurance Information

Applicant's Insurance *

Please upload a copy or photo of your child's insurance card. *

Drag & Drop Files, Choose Files to Upload You can upload up to 3 files.

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I/We the parent/guardian of the applicant(s) understand and agree (please read then check all boxes): *

This application will be processed when all required documentation is received.
In place of tuition, I am required to fulfill Parent Tuition Hours yearly. Families with 1 child enrolled are required to complete a minimum of 10 tuition hours each year. Families with 2 or more children enrolled are required to complete a minimum of 15 tuition hours each year. Failure to complete required Tuition Hours will result in inability to re-enroll for the next school year.
Small Steps Nurturing Center may have mental health professionals, speech pathologists, occupational/physical therapists and/or mental health interns observing, consulting and/or providing direct intervention for physical, social emotional, and developmental concerns in my child’s classroom, and I give my consent to any such intervention. I understand that any direct interventions regarding confidential therapeutic services, requires my written consent, and that it is my/our responsibility to follow up with any referrals given.
As a condition of enrollment, a signed Parental Consent Request Form, allowing Small Steps to track each child’s progress through school, will be required.
Transportation will be provided only to parents that have no means of getting their child to and from school.

By checking the above boxes you are confirming that you understand and are in agreement with the requirements of applying to Small Steps Nurturing Center.

Signature *

Clear Signature

Date *

Document Uploads

Student's Birth Certificate *

Drag & Drop Files, Choose Files to Upload

Student's Social Security Card *

Drag & Drop Files, Choose Files to Upload

Valid ID/Driver license/Passport *

Drag & Drop Files, Choose Files to Upload You can upload up to 2 files.

Two Proofs of Residencies (Must have the same address) *

Drag & Drop Files, Choose Files to Upload You can upload up to 2 files.

Income Verification *

Drag & Drop Files, Choose Files to Upload You can upload up to 5 files.

SNAP Award Letter, Notarized Employment Letter, Two Most Recent Pay Stubs, or Most Recent Tax Return)