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LCNS Registration for 2017-2018
Child's Information
Child's Last Name *
Your answer
Child's First Name *
Your answer
Child's Nickname:
(If applicable)
Your answer
Child's Gender *
Required
Child's Date of Birth *
MM/DD/YYYY
Your answer
Child's Age on Sept 1, 2017 *
Your answer
Information for School Correspondence & Directory
Enrollment Selection *
Please select the class choice for your child
Required
Mother's/Guardian's Last Name *
Your answer
Mother's Guardian's First Name *
Your answer
Father's/ Guardian's Last Name *
Your answer
Father/Guardian's First Name *
Your answer
Street Address *
Your answer
City *
Your answer
Zip Code *
Your answer
Preferred Phone Number *
XXX-XXX-XXXX
Your answer
Phone Type *
Required
Alternate Phone Number
XXX-XXX-XXXX
Your answer
Phone Type
Primary Email Address *
Your answer
Secondary Email Address
Your answer
LCNS Board of Directors
Are you interested in serving on the LCNS Board?
Are you interested in serving on the Fundraising Committee?
How did you hear about LCNS?
I have read and understand LCNS' Registration Policies *
Please see the Registration Policies document on www.lcns.org or contact the Director for a copy.
Required
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