Admissions Paperwork for PRe-K and Kindergarten

All students admitted to Northstar School’s PreK program are required to complete a series of County forms required by Child Care Licensing.  The core mission of the Child Care Licensing Program is to ensure the health and safety of children in care. Additionally, Northstar also requires a few documents to be filled and submitted. Once all paperwork has been completed and uploaded, your application to Northstar School will be considered complete.

All kindergarten students must submit an Oral Health Examination Form by April 1st of his/her kindergarten year of school. Please click below to obtain the form.

Please let us know if you have any questions. You may contact us by emailing at or calling at 510-397-1501.

Pre-K Forms

The County has requested for Pre-K families to fill out several forms that Northstar will keep in their individualized student folders. Please fill out each of these and save them to your computer. All forms will be uploaded by clicking on the button below.

PRE-K County Forms:

Please fill out the following forms included in this COMBINED PDF (click here) and upload by clicking the button below:

  1. LIC 613A Personal Rights Admission Agreement
  2. LIC 627 Consent for Emergency Medical Treatment 
  3. LIC 700 Identification and Emergency Information
  4. LIC 701 Physician’s Report 
  5. LIC 702 Child’s Pre-Admission Health History
  6. LIC 995 Notification of Parents’ Rights


School Forms:
  1. Financial Agreement (click here) online form to complete (no need to upload)
  2. Health Examination Form (click here) – This form needs to be signed by a physician. Fill out, print, save to upload.
  3. Birth certificate– Please upload a copy of your child’s birth certificate below.
  4. Immunization Records– Please upload a copy of all other state required vaccinations and immunization records below.
Please upload all forms here
Oral Health Assessment Form - Kindergarten

All Kindergarten students must submit proof of a dental exam by April 1st of his/her year of school. Please click on the link below to print this form, and have it signed by your dentist. The completed form should be returned to the school office or emailed to

Print Oral Health Assessment Form
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