PRE REGISTRATION FORM

Child's Name*

Child's Date of Birth (MM/DD/YYYY)*

Email address*

Phone Number*

Full Time or Part Time?*

Care Days & Hours (Ex. Monday 9am - 2pm)*

Does your child have an ELC voucher? YES or NO*

Date of Enrollment (MM/DD/YYYY)*

What are you looking for in a preschool?*

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