Noah's Ark Kinder Prep Registration form 2018-2019
Please fill out one form per student - Registrations are NOT guaranteed until we have received the registration FEE which is the same as the student's monthly tuition, however it is non -refundable after March 15, 2018.
I understand that by filling out this form I am registering my student for the M/W/F 8:45-11:45 class for 4/5 year old with a tuition of $135.00 per month. *
Required
Child's First Name *
Your answer
Child's Last Name *
Your answer
Nickname
Your answer
Birthday *
MM
/
DD
/
YYYY
Age as of Sept 1st 2018 *
Gender *
Parent 1 First Name *
Your answer
Parent 1 Last Name *
Your answer
Parent 1 Cell Phone Number *
Your answer
Parent 1 Work Number *
Your answer
Parent 1 Email Address *
Your answer
Parent 2 First Name *
Your answer
Parent 2 Last Name *
Your answer
Parent 2 Cell Phone Number *
Your answer
Parent 2 Work Number *
Your answer
Parent 2 Email Address *
Your answer
Child lives with *
Child's Address *
Your answer
Name's And Ages Of Siblings
Your answer
Church Home *
Your answer
If not a member of Brandon Lutheran Church are you interested in more information?
How will your child get to school *
Drop Off Contact First Name *
Your answer
Drop Off Contact Last Name *
Your answer
Drop Off Contact Phone Number *
Your answer
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