IMK Preschool Enrollment
Child Enrollment Information
* Required
Email address
*
Your answer
Name of Child
*
Your answer
Birth Date
*
MM
/
DD
/
YYYY
Sex
*
Male
Female
Other:
PASSWORD (to be used over the phone)
*
Your answer
Address
*
Your answer
City / State / Zip Code
*
Your answer
First Date of Attendance
MM
/
DD
/
YYYY
List of Known Allergies
Your answer
Special Needs
Your answer
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