2017-18 Stephens City United Methodist Preschool Registration Form
Please fill out the following form.  If you have any questions please call the preschool office at 540-869-1368 or email stephenscitypreschool@gmail.com 

A $50.00 registration fee must be submitted to Stephens City United Methodist Preschool In order to complete registration for the 2017-18 school year.  Registration is not guaranteed until the $50.00 registration fee is received.  The registration fee can be dropped off at the Preschool Office or mailed to Stephens City United Methodist Preschool at P.O. Box 428, Stephens City, VA 22655.  
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Email *
Name of Child *
(Last, First, Middle Initial)
Parent/ Guardian Name(s) *
First and Last Name
Date of Birth *
Month/ Date/ Year
Student Gender *
Required
Parent/ Guardian Home Phone Number *
Parent/ Guardian Cell Phone Number *
Additional Phone Numbers
Address *
City *
Zip Code *
Additional Email Addresses *
Preschool Program of Choice *
Required
Please mark your enrollment preference.  Please enter your second choice in the "Other" box. *
We will try our best to give your your 1st preference.  However, due to the number of classes available we may need to go to your next choice.  
Required
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