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CHIPS Pre-registration application 2025-26
Please note that priority is given to Chelmsford residents.
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Child's Full Name *
Sex *
Date of Birth *
MM
/
DD
/
YYYY
Parent/Guardian Full Name(s) *
Home Address *
Preferred Phone Number *
Preferred Email *
Have any of your other children attended CHIPS?
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Preference for Session *
2 Days AM ($120/mo)
3 Days AM ($175/mo)
4 Days AM ($230/mo)- 4 year olds
2 Days PM ($120/mo)
3 Days PM ($175/mo)
4 Days PM ($230/mo)- 4 year olds
First Choice
Second Choice
Does/did your child receive Early Intervention services? *
Does your child have any special needs *
If yes, please specify:
Other comments:
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