Preschool Enrollment Application 2018-2019
Child's Name (Last, First) *
Your answer
Address *
Your answer
City & Zip Code *
Your answer
Home Phone *
Your answer
Age *
Your answer
Date of Birth *
MM
/
DD
/
YYYY
Male/Female *
Church Affiliation *
Your answer
Trinity Lutheran Church Member *
Required
Schedule Choice *
Number of Days Attending *
Required
Which days will your child be attending? *
Required
Parents are: *
Parent(s) Living with Child (Mother) *
Your answer
Occupation *
Your answer
Work Phone *
Your answer
Cell Phone *
Your answer
Email Address *
Your answer
Parent(s) Living with Child (Father) *
Your answer
Occupation *
Your answer
Work Phone *
Your answer
Cell Phone *
Your answer
Email Address *
Your answer
Parent(s) Not Living with Child (Mother)
Your answer
Occupation
Your answer
Work Phone
Your answer
Cell Phone
Your answer
Email Address
Your answer
Parent(s) Not Living with Child (Father)
Your answer
Occupation
Your answer
Work Phone
Your answer
Cell Phone
Your answer
Email Address
Your answer
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