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Kids' Community Application Form
We are glad that you are applying to Kids' Community Early Education Center! After submitting your application, you will be contacted shortly.
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Student's name:
Your answer
Class applying for:
PreK (student turns 4 by August 15, 2023)
Kindergarten (student turns 5 by August 15, 2023)
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School year applying for:
2023-2024
Other:
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Student address: (include street, city, state, and zip code)
Your answer
Home phone (if applicable):
Your answer
Student's date of birth:
MM
/
DD
/
YYYY
Student's place of birth: (city and state; include country if born outside of the United States)
Your answer
Baptized member of the Seventh-day Adventist Church:
Yes
No
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Baptism date:
MM
/
DD
/
YYYY
Church of membership:
Your answer
Any allergies or heart problems:
Your answer
Any physical disabilities or special needs:
Your answer
Does your disability prevent you from participating in the physical education program?
Your answer
Any learning disabilities:
Your answer
Names and ages of siblings:
Your answer
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