Parent/Caregiver Name *

First Name

Last Name

Phone Number *

(###)

###

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Programs I'm Interested In: *

Check all that apply.

Pre-K & Kindergarten (4 ½ - 6 yrs)

Preschool (3 - 5 yrs)

Transitional Preschool (2 - 3 yrs)

Extended Care (2 - 6 yrs - School Year Programs Only)

Number of Days per Week I'm Interested In Enrolling In: *

Check current top choice.

M - F

M / W / F

T / Th