JMPNS Enrollment Application
Sign in to Google to save your progress. Learn more
Child's First Name *
Child's Last Name *
Child's Date of Birth *
MM
/
DD
/
YYYY
Parent's First Name *
Parent's Last Name *
Email Address *
(you will receive confirmation & enrollment info at this address)
Primary Phone Number
Address *
City, State, Zip *
Second Contact Number
Desired Enrollment Year (Check All That Apply) *
Required
Class Preference *
Family's Current Status *
Continuing & Alumni Families please indicate class and year
How did you hear about us? *
Commitments
- attend quarterly business meetings and complete 12 hours for caregiver training/support  
- participate in the classroom, one day per week, for the duration of the school year (Must stay for your child's entire class time)
- Participation in fundraising
-1 committee job per enrolled child

*requirements are subject to change with board approval
Important!
Your child will not be placed onto the JMPNS wait list until this form has been submitted and received by the Participation Chairperson.
Your placement on the wait list will be confirmed via e-mail upon receipt of this form -- usually within 10 days.
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report

Google Forms