Kiddy City Preschool @ Mohns Hill Church
Application for Enrollment 2024-2025
Sign in to Google to save your progress. Learn more
Email *
*Please check the class for which your child is applying: (Birthdate by Sept 1st) *
Required
** Please note that the full school year price includes a 2.5% discount for paying in full at the time of first payment by the first day of school.
Child's Name *
Nickname
Child's birthdate *
MM
/
DD
/
YYYY
Street Address, Town, Zip Code *
Father's Name
Father's e-mail
Father's Home Phone Number
Father's Cell. Phone Number
Father's Work Phone Number
Father's Street Address  (*if different)
Mother's Name
Mother's e-mail
Mother's Home Phone Number
Mother's Cell. Phone Number
Mother's Work Phone Number
Mother's Street Address (*if different)
Child's Physician and Phone Number
*If we are unable to reach a parent in an emergency, is there someone else we could contact? (Grandparent/friend/neighbor) *
Emergency Contact Phone Number *
*Other Members of Household: List Name / Age / Relationship
*Does your child have any special needs of which we should be aware of? (Physical limitations, allergy, speech, behavior, family history) Briefly explain:
*What do you hope your child will gain from this preschool experience?
*How did you hear about Kiddy City Preschool?
*Does your family currently attend a church?
Clear selection
*Questions you might have about our preschool program?
As we anticipate the start of preschool we would like to have a headshot picture of your child. This will help to familiarize us with each student who will be coming in September. Please send this picture with your application. Thank you!   PARENT SIGNATURE & DATE *
** Application is not complete until a $30 Registration Fee (Non-refundable) is received **Make checks payable to Mohn’s Hill EC Church (Please write your child’s name on check) Mail $30 Registration Fee to: Kiddy City Preschool @ Mohn’s Hill EC Church 708 Mohn’s Hill Road Reading, PA 19608
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
This form was created inside of Mohns Hill Church. Report Abuse