Preschool Admission Form

Preschool Admission Form

Please fill out this form completely to enroll your child in our preschool program.

Child’s Information

Name

    Date of Birth

      Age

        Gender

          Address

            Parent/Guardian Information

            Name

              Relationship to Child

                Phone number

                  Email

                    Emergency Contact Information

                    Name

                      Relationship to Child

                        Phone number

                          Health Information

                          Does your child have any allergies, medical conditions, or special needs?

                          If yes, please specify

                            Enrollment Preferences

                            Preferred Start Date

                              Days Attending

                                • Monday

                                • Tuesday

                                • Wednesday

                                • Thursday

                                • Friday

                                • Saturday

                                • Sunday

                                Signature

                                By signing this form, I confirm that the information provided is accurate and complete.

                                Name:

                                Date:

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