Utica Community Schools Early Childhood Programs: Pre-registration
Open to all In District and Out of District families looking to enroll for the 2020-2021 school year.

Please note:
- Completing this form is not a confirmation of registration.
- Once families complete form, an Early Childhood representative will contact you to confirm class selection and process your payment. Please have your credit card information prepared.
- Once payment is complete, you will receive a separate email with class confirmation.

Email address *
Select which program you are pre-registering for: *
1st Choice: Which class would you like to pre-register for? For example: 2201-20 Collins, Ms. Pennazoli, AM *
Your answer
2nd Choice: Which class would you like to pre-register for? For example: 2202-20 Collins, Ms. Pennazoli, PM *
Your answer
3rd Choice: Which class would you like to pre-register for? For example: 0801-20 Browning, Ms. Edwards, AM *
Your answer
UCS District Resident? *
If you are an In District family, please list your homeschool:
Your answer
Primary Payer Name (Last Name, First Name) *
Your answer
Primary Payer Address (Street, City, State, Zip Code) *
Your answer
Primary Payer Phone Number *
Your answer
Student Name (Last Name, First Name) *
Your answer
Student Address (Street, City, State, Zip Code) if different from Primary Payer
Your answer
Student Date of Birth *
MM
/
DD
/
YYYY
*I understand that by completing this form I am "pre-registering" my child. I also understand that my child is not registered until payment is complete and I have received a confirmation email. *
Required
How did you hear of our Early Childhood programs? (eg. website, facebook, community event, etc.) *
Your answer
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