Application

Application for Admission

If you are interested in enrolling you child; please fill out the application below and we will contact you for next steps!

Child's Legal Name

First Name

Last Name

Preferred First Name

Child's Gender Identification

Date of Birth

YYYY

Parent / Guardian #1

Relationship to Child

Occupation

Street Address, City, State, Zip

Phone Number

(###)

###

####

Parent / Guardian #2

Relationship to Child

Occupation

Street Address, City, State, Zip

Phone Number

(###)

###

####

Please Select the Program Option Applying for

Desired Start

If you are interested in starting the program as soon as we open, May-August 2020, please write ASAP. Otherwise, include the date of desired start.

What are your expectations and desires for your child out of their participation in our program?

Please describe if your child has any special needs, allergies, health concerns, or dietary restrictions?

Do you have any concerns about your child’s social, cognitive, or physical development?

The following special accommodation(s) may be required to most effectively meet my child’s needs while at preschool

Does your child have any experience using the toilet?

For Primary students we do require that children are able to use the toilet independently?

Drop Off/Pick Up Plan

How do you plan to drop off/pick up your child? Walking, biking, or via car utilizing our curb side drop off/pick up zone?

Is there anything else that you would like to share with us?

“Teachers who love teaching, teach children to love learning.”

— Robert Meehan, author

Childcare License #: 384004262, 384004541