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Enrollment Application 
Thank you for your interest! Please complete the following information and we will be in touch with you soon. 
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Email *
Phone Number *
How did you hear about us? *
Name of child(ren) interested in the program: *
Birth date of child(ren) interested in the program: *
Parent/guardian names: *
Which days of the week would you like your child(ren) to attend?
Would you be interested in a half-day program if it was offered? *
Is there anything you would like to adD? *
Thank you!
We will contact you shortly to confirm your requested schedule.  We look forward to speaking with you!
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