Loomis Community Preschool - Application For Enrollment {2017-18}
6414 Brace Road, Loomis, California 95650
loomispreschool.com
License #310-300416

Children are accepted without regard to race, color, religion, or national origin.

This application and a non-refundable $75 registration fee are required to secure your child's spot in the class. You can pay via Paypal at the end of this application, or by check. Thank you!

Child's Name (Last, First)
Your answer
Select one:
Child's Age
Your answer
Child's Sex
Birthdate
MM
/
DD
/
YYYY
Street Address
Your answer
City
Your answer
Zip Code
Your answer
Home Telephone (000-000-0000)
Your answer
Does your child have any health problems or disabilities?
Your answer
Next
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms