KinderHaus Pre-Enrollment Application
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Your Name *
Your eMail *
Your Phone Number *
Child's first name *
Child's middle name *
Child's last name *
Child's nickname *
Child's birthday or approximate due date *
Child's gender *
Child's primary language *
Parent/guardian's primary language *
Child's home address *
City *
State *
Zip code *
Days attending *
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!)
Any that apply
Clear selection
Notes you would like to add
Clear form
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