Application

CHILD
Name of Child
Name of Child
Which program are you applying for?
Children who turn 2 by March 1, 2019 are eligible for the 2 and 3 Day Program, only. Children who turn 3 by Sept 1, 2019 are eligible for either the 2,3 or 5 Day programs. Children over the age of 5 by December 1, 2019 must enroll in the 5 Day program. CHILDREN UNDER THREE BY DECEMBER 1: HOURS ARE 9.35 - 12.30.
Are you applying for Tuition Assistance?
Admission decisions are unrelated to Tuition Assistance decisions; however, Tuition Assistance applications should be filed immediately following the application for admission.
Gender
Parent/Guardian 1
Address
Address
Phone
Phone
Current Status of Parent
Business Phone
Business Phone
Parent/ Guardian 2
Name
Name
Address
Address
Phone
Phone
Business Address
Business Address
Business Phone
Business Phone
Current Status of Parent
Supplemental
Does your child have an existing or pending special ed., special need or IEP document?
Has your child been asked to withdraw from any of these? *