Pre-Registration Form New Student: Returning Student: Date: Potty Trained: NoYes Child's Name: Birthdate: Age on 09/01/10: Address: City: State: Zip: Email: Mother's Name: Home Phone: Business Phone: Cell Phone: Father's Name: Home Phone: Business Phone: Cell Phone: Full Time (7:00am-6:00pm) Class Choice (for children 6 wks - Pre-K) Monday - Friday: Monday, Wednesday & Friday: Tuesday & Thursday: Part Time (9:30am-2:30pm) Class Choice (toddler - Pre-K) Monday - Friday: Monday, Wednesday & Friday: Tuesday & Thursday: Family Discount - 10% for second and subsequent children enrolled (applied to the lesser amount).Discount for paying full-year tuition on or by September 1, 2009 - 5% Registration Fee is required to reserve a space Financial assistance available, please see Director for application.
New Student: Returning Student:
Date:
Child's Name:
Birthdate:
Address:
City:
Email:
Mother's Name:
Business Phone:
Father's Name:
Full Time (7:00am-6:00pm) Class Choice (for children 6 wks - Pre-K)
Monday - Friday:
Monday, Wednesday & Friday:
Tuesday & Thursday:
Part Time (9:30am-2:30pm) Class Choice (toddler - Pre-K)
Financial assistance available, please see Director for application.
