2018-2019 Online Application

This is the online application for the 2018-2019 school year.

* Child's Name:
* Address:
* Date of Birth: Month: Day:    Year:   * Sex:
* Parent Name:
Occupation:
* Home Phone: Work Phone:
* Email: Cell Phone:
Does your child have a preferred nickname?
Has your child previously attended daycare or school? If so, which:
Please describe your child including his/her strengths and the things he/she is currently working on:
Do you have any concerns about your child’s development?
What are your hopes/expectations for your child through this program?
* What is the best time for contacting you?   
* What is the best method for contacting you?   
Are you considering using early morning drop off or the extended day option?
Early dropoff: Extended day:
Please choose your preferred schedule below. You can make up to three choices total with 1 representing your first choice and 3 representing your third choice.
* Full Day 7:45am-6pm
5 days:
3 days:
2 days:
* School Day 8:30am-3pm
5 days:
3 days:
2 days:
* Mornings 8:30pm-12pm
5 days:
3 days:
2 days:
 * Required