JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
KinderHaus Pre-Enrollment Application
Completion of this pre-enrollment application is required for application and wait list. This form will enable us to better understand your child and meet their needs. Please be aware that submitting an application does not necessarily guarantee your child’s admission.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Your Name
*
Your answer
When Are Childcare Services Needed to Start?
*
MM
/
DD
/
YYYY
Your email
*
Your answer
Your Phone Number
*
Your answer
Child's first name
*
Your answer
Child's middle name
*
Your answer
Child's last name
*
Your answer
Child's nickname
*
Your answer
Child's Birthdate (or estimated due date)
*
MM
/
DD
/
YYYY
Child's primary language
*
Your answer
Parent/guardian's primary language
*
Your answer
Child's home address
*
Your answer
City
*
Your answer
State
*
Your answer
Zip code
*
Your answer
Days attending
*
Monday
Tuesday
Wednesday
Thursday
Friday
Required
May we ask how you heard about KinderHaus?
Local Referral (family or friend)
Social Media (Facebook, etc)
Web Search (Google, etc)
Not exactly sure! (heard of you!)
Notes you would like to add
Your answer
Submit
Page 1 of 1
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
Forms
