Preschool Enrollment Form 2024-2025
Preschool Enrollment
Sign in to Google to save your progress. Learn more
Email *
Child's First, Middle & Last Name *
Age *
Date of Birth *
MM
/
DD
/
YYYY
Address, City, State, Zip Code *
Mother's Name *
Mother's Cell Phone Number *
Mother's Work Phone Number *
Mother's Full Address (if different from the child)
Mother's Email *
Mother's Place of Employment
Father's Name *
Father's Cell Phone Number *
Father's Work Phone Number *
Father's Full Address (if different from the child)
Father's Place of Employment
Father's Email *
Name and phone number of child care provider *
How can parents be reached during school hours? *
Child lives with (name, age, relationship)-Parent/Guardian/Siblings *
List an additional person to contact in case of emergency: *
Do you give the preschool staff permission to treat minor injuries? *
Does your child have any allergies? *
If your child has any allergies, please list them *
Does your child have any development delays? *
If yes, please explain *
Is your child used to playing in a group setting? *
Please list a few of your child's favorite activities *
How do you view your child's activity level? *
How long does your child attend to stories, TV shows or movies? *
How does your child deal with frustration? *
Is your child toilet trained? *
Can your child dress self? *
Can your child feed self? *
What fears does your child have? *
What comforts your child, when troubled? *
How do your family deal with behavioral issues? *
Does your child become upset in a new situation? *
Please describe any traumatic events you feel the staff should know about: *
Is your child right or left hand dominant *
Where will your child attend Kindergarten? *
What is your child's home school district? *
Do you give permission for our preschool to share information with other agencies that have provided services to your child and vice versa? *
Please list any other agencies who are providing services to your child *
Do you give your child permission to go on field trips or walks with the preschool? *
Information about our classes
M/W/F Morning (9:00-1:00) ($200.00/month)-Must be toilet trained-Kindergarten readiness curriculum for children who will attend kindergarten the following year.  Child will need to bring their lunch.

M/W (9:00-11:30) ($100.00/month)-first preschool experience curriculum for children ages 3-4 who will not attend kindergarten the following year- staff can work with toilet training, as long as child is close to being toilet trained at home and can wear a pull up.


Please indicate which class you wish your child to be placed in *
Please write a short paragraph about your child to help us become familiar with him/her *
Parent/Guardian Signature *
Date *
MM
/
DD
/
YYYY
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