Early Childhood Application 2018-19
Email address *
Parent 1 Name (first, last) *
Your answer
Parent 1 Cell Phone *
Your answer
Parent 1 Home Phone *
Your answer
Parent 1 Email Address *
Your answer
Parent 1 Occupation *
Your answer
Parent 1 Home Address *
Your answer
Parent 2 Name (first, last) *
Your answer
Parent 2 Cell Phone *
Your answer
Parent 2 Home Phone
Your answer
Parent 2 Email Address
Your answer
Parent 2 Occupation *
Your answer
Parent 2 Home Address (if different than Parent 1)
Your answer
Kindergarten Half Days 8:30 - 12:30 (ages 3 - 6)
Kindergarten Full Days 8:30 - 3 (ages 3 - 6)
Would you be interested in our After-School Program? Offered daily from 3:00 - 5:30 *
Child's Full Name (first, middle initial, last) *
Your answer
Child's Date of Birth
MM
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