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  2010-2011 PRE-REGISTRATION
CHILD'S INFORMATION
Child's Name:
Home Phone:
E-mail:
Street Address:
City
Zip:
Birthdate:
Age: Sept 1, 2009: Years Months
Gender:
Days of Attendance: Tuesday, Wednesday & Thursday
Number of Days
Which Days
Pre-Kindergarten and the Transitions Classes are 3 day programs
FAMILY INFORMATION
Mother's Name
Mother's Employer
Work Phone #
Cell Phone #
Father's Name
Father's Employer
Work Phone #
Cell Phone #
The school will confirm your registration request in a timely manner.
pay registration on-line here
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