Fishtown Playschool Membership Form
$30 non-refunded fee is due with this form. Payment is accepted in PayPal or check. Checks should be made out to Fishtown Playschool and delivered c/o Mary Ann Lukens 708 North 5th Street, Philadelphia, PA 19123.

Once payment is received, someone from the Membership Committee will contact you to schedule a classroom visit. Thank you for your interest in Fishtown Playschool! Email us at info@fishtownplayschool.org with any other questions.

Fishtown Playschool is a parent-run, parent-governed playgroup cooperative. Fishtown Playschool admits families of any race, color, religion, marital status, national or ethnic origin, disability or sexual orientation to all rights, privileges, programs, and activities generally accorded or made available to member families.

Applicant's first name *
Your answer
Applicant's last name *
Your answer
Applicant's gender *
Age *
Your answer
Birthday *
MM
/
DD
/
YYYY
Kindergarten year *
Your answer
Parent 1 name *
Your answer
Phone number *
Your answer
E-mail address *
Your answer
Occupation and workplace
Your answer
Parent 2 name
Your answer
Phone number
Your answer
E-mail
Your answer
Occupation and workplace
Your answer
Child's home address *
Your answer
Name and age of sibling(s)
Your answer
Describe your child in three words *
Your answer
How did you learn about Fishtown Playschool? (Please be specific) *
Your answer
Please tell us why you are interested in Fishtown Playschool *
Your answer
What other preschool programs, if any, have you applied to? *
Your answer
Where do you expect your child to attend PreK and Kindergarten? *
Your answer
Does your child have any allergies or conditions requiring special needs? *
Your answer
My child meets the current immunization schedule recommended by the Center for Disease Control. *
(Current immunizations are required for all Fishtown Playschool students.)
As a cooperative, all families are required to spend time in the classroom each month as Parent Helpers. Depending on enrollment, the commitment is usually 3 times a month. *
Is this a concern for your family?
Fishtown Playschool is a cooperative that relies on family involvement. Which skills would your family be able to share with FPS? *
i.e. music class, yoga instruction, carpentry, fundraising, legal help, CPA...
Your answer
Our by-laws state that each family should serve on at least one committee. *
Based on your areas of expertise, where do you think your strengths would fit?
Required
I certify that all information is correct to the best of my knowledge *
Type full name to confirm
Your answer
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service