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Madison Metropolitan School District

MMSD Peer Model Program Application

2021-2022 Peer Model Applications will be accepted starting on March 1, 2021.  Applications will be reviewed beginning in April, and additional forms will be sent at that time. Thank you for your interest. 

Required

Child's Namerequired
First Name
Last Name
Must contain a date in M/D/YYYY format
Genderrequired
EthnicitySelect one or more of the following categories that apply to this student:
Select one or more of the following categories that apply to this student:
Parent/Guardian Name(s)required
First Name
Last Name
Parent/Guardian Name(s)
First Name
Last Name

Being an Early Childhood Peer Model provides an opportunity for typically developing children to be integrated into the MMSD Early Childhood Special Education classrooms. Peer models serve as role models for MMSD children who require special education services for educational disabilities. Peer Models engage with and model positive peer interactions. Peer models may also demonstrate age-appropriate play, early learning, behavior, communication, social skills, self-care, motor skills, and speech and language skills.

2. Is your child able to speak fluent English in an age appropriate manner?required
3. Is your child toilet trained?required
4. Has your child received any type of services through MMSD or an outside agency?required
5. Has your child ever been identified as having a disability?required
6. Please check the schools you would be willing to attend below:required
7. If your preferred school is not available, would you be interested in attending a different location?required
8. Is your child currently enrolled (or will be in September) in a preschool?required
12. Does your child have any health concerns?required

If you have questions, call the PreK Information Line at 608-663-8471.


With respect to educational programs, no person shall be denied admission to any District school, or be denied participation in, be denied the benefits of, or be discriminated against in any curricular, extracurricular, pupil services, recreational or other program or because of the person's sex, race, national origin, ancestry, religion, creed, pregnancy, marital or parental status, sexual orientation, gender identity, gender expression, or disability including her or his physical, mental, emotional, or learning disability.