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Thank you for your interest in Bezos Academy. We are currently accepting applications for Bezos Academy Des Moines. Applications for Bezos Academy Tacoma McCarver will begin in May 2021.

This application is for Bezos Academy Des Moines (824 S 216th Street, Des Moines, WA 98198). Please complete one application per child. This application must be completed by a primary guardian.

COVID-19: We at Bezos Academy are closely monitoring COVID-19 in the community. Bezos Academy is committed to the health and well-being of our students, families, and staff. We follow guidelines from the Washington State Department of Health and US Center for Disease Control and Prevention (CDC) for child care. Bezos Academy is maintaining a small class size, requiring facial covering for all staff and students, conducting temperature screening at arrival, implementing physical distancing strategies, intensifying cleaning and disinfection efforts, and increasing fresh air ventilation and time outside.

Application information: The information on your application is confidential and used to determine your child’s eligibility for our program. If your child enrolls in Bezos Academy, this Application Form will become a part of your child’s file that we will maintain according to the Washington State Department of Children, Youth & Families regulations. We do not require, check, or report on immigration status.

We review applications in the order they are received and anticipate our program will fill up fast, so please apply as soon as you can. We will contact you within a week of receiving your application and let you know if your child is admitted to the program or is waitlisted.

Eligibility: To be eligible for our 2020-21 school year program, your child must be 3 or 4 years old by September 1, 2020. To be eligible for the 2021- 22 school year, your child must be 3 or 4 years old by September 1, 2021. The child must be toilet trained or can be reasonably accommodated for toileting by the time of enrollment. In addition, eligibility is determined by household income. A household is defined as all the people (adults and children) who live in the same housing unit (house, apartment, condo etc.), whether they are related to each other or not.  Household income is the total annual income from everyone in the household. To be eligible for Bezos Academy the student’s annual household income must be less than 400% of the Federal Poverty Level (FPL) as defined by the table below. Bezos Academy reserves half of the seats for students coming from families with an income less than 250% of FPL. If your income is more than the income listed, you are ineligible for our program.

# of People in Household Less than 250% of FPL: Less than 400% of FPL:
2 $43,100 $68,960
3 $54,300 $86,880
4 $65,500 $104,800
5 $76,700 $122,720
6 $87,900 $140,640
7 $99,100 $158,560
8 $110,300 $176,480
9 $121,500 $194,400
10 $132,700 $212,320

Admission preferences are provided to children who are homeless or living in foster care, siblings of existing Bezos Academy students, and the children of community partners.

Please contact us at desmoines@bezosacademy.org or 206-653-7444 if you need help to complete the application.

Thanks,
Bezos Academy Des Moines
824 S 216th St
Des Moines, WA 98198

☐ 2020-21
☐ 2021-22
☐ Des Moines

Child Information

To be eligible for our program, your child must be three or four years old by September 1, 2020.
☐ M
☐ F
☐ English
☐ Spanish
☐ Vietnamese
☐ Somali
☐ Amharic
☐ Other:
☐ Spanish
☐ Vietnamese
☐ Somali
☐ Amharic
☐ Other:
☐ Yes
☐ No

Child Development Support

All students deserve an appropriate education in their least restrictive environment, the environment in which they can be most successful as a student. The Bezos Academy policy is to accept all students in compliance with the Americans with Disabilities Act (ADA), its regulations, and any other applicable local, state, or federal laws pertaining to the provision of services to individuals with disabilities. Each child’s least restrictive environment is individualized, and Bezos Academy is committed to reviewing each student’s needs on a case-by-case basis. Reasonable accommodations will be made for any child whose least restrictive environment can be met in a group care setting. Bezos Academy will not exclude children with disabilities from our programs unless their participation requires a fundamental alteration of the program to meet their needs.

Living Arrangement and Household Income

We prioritize children who are homeless or living in foster care during the admission process, please provide your child’s current living arrangement:
☐ Temporary Housing (shelter, transitional or temporary housing, tent, car, or similar location)
☐ Permanent Housing (house, apartment, townhouse, or condo)
☐ Foster Care

Household Information:
A household is defined as all the people who live in the same housing unit (house or apartment), whether they are related to each other or not.

Please estimate your yearly household income and include any earnings from work (Salary, wages, cash bonuses), public assistance (unemployment benefits, worker’s compensation, veteran’s benefits) and child support for all members of the household. In the question below, please select the number of people in the household, and select the income range that includes your estimated yearly income. If your income is more than the income listed you are ineligible for our program.

☐ 2 people. Income $0-$43,100
☐ 2 people. Income $43,100-$68,960
☐ 3 people. Income $0-$54,300
☐ 3 people. Income $54,300-$86,880
☐ 4 people. Income $0-$65,500
☐ 4 people. Income $65,500-$104,800
☐ 5 people. Income $0-$76,700
☐ 5 people. Income $76,700-$122,720
☐ 6 people. Income $0-$87,900
☐ 6 people. Income $87,900-$140,640
☐ 7 people. Income $0-$99,100
☐ 7 people. Income $99,100-$158,560
☐ 8 people. Income $0-$110,300
☐ 8 people. Income $110,300-$176,480
☐ 9 people. Income $0-$121,500
☐ 9 people. Income $121,500-$194,400
☐ 10 people. Income $0-$132,700
☐ 10 people. Income $132,700-$212,320

Parent / Guardian 1

Please provide your contact information.

☐ Biological/Adoptive Parent
☐ Foster Parent
☐ Other:

Parent / Guardian 2

☐ Biological/Adoptive Parent
☐ Foster Parent
☐ Other:

Background

Acknowledgment

By typing my name in the box below, I promise that the information on this form is true and correct. If I knowingly provide false information, I understand my child may not be able to enroll in the program. I understand that information from this application is entered into the Bezos Academy database and will become a part of my child’s file if they enroll. No information related to immigration status is required, checked or reported on by Bezos Academy. Information in the databases may be used for:
- Admission and enrollment into the Bezos Academy program
- Research studies to determine the benefits of attending a Bezos Academy.

Nondiscrimination Policy

Bezos Academy does not discriminate on the basis of any race, color, national origin, ethnic origin, gender, religion, creed, cultural or family background or beliefs, family structure, gender identity, sexual orientation, disability, language, citizenship or immigration status, ancestry, or any other characteristics protected by federal, state or local laws in the administration of its educational policies, admissions policies and school-administered programs.