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Pre-K Pre-Application Form

Thank you for your interest in our Pre-K program! Please complete this form to begin the enrollment process.

Child's Information

Child's Name

Date of Birth

Home Address

Primary Language

Parent/Guardian Information

Parent/Guardian Name

Parent/Guardian Phone Number

Emergency Contact (Other Than Parent/Guardian)

Emergency Contact Name

Emergency Contact Phone Number

Relationship to Child

Additional Information

Does your child have any allergies or medical conditions?

Yes No

If yes, please explain: