Preschool Promise Interest Form
Email address *
Contact Information
Child First Name *
Share the child that is next in line for Preschool
Child Last Name *
Child Birthday *
MM
/
DD
/
YYYY
Will this child be 4 on or before September 30, 2020? *
Adult First Name *
Adult Last Name *
Street Address *
Address 2 (Apt/Suite)
City *
State *
Zip Code *
Phone Number *
Please use this format 937-222-2222
Child 2 First Name
Child 2 Last Name
Child 2 Birthday
MM
/
DD
/
YYYY
Will this child be 4 on or before September 30, 2020?
Clear selection
Child 3 First Name
Child 3 Last Name
Child 3 Birthday
MM
/
DD
/
YYYY
Will this child be 4 on or before September 30, 2020?
Clear selection
Program Sign-Ups
“I permit Preschool Promise to share my contact information, i.e. my name, phone number, email address, address, child(ren)’s name, child(ren)’s birth date with
I would like my child to attend the following preschool for the 2020-21 School Year
If you answered other, please write preschool name below
Does your child already attend this Preschool?
Clear selection
Who is completing form? *
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