Preschool & PreK PLUS Registration Interest Form

For families needing additional learning hours

Please complete the Preschool & PreK PLUS Interest Form below. A member of our team will review it and be in touch with you shortly. If you have more than two children to enroll in the program, please complete the form more than once.

Registration Fee: $199
(Full amount due regardless of start date)

If you have an immediate need, please contact our office at 480.813.2796

You can also download a copy of the Preschool & PreK PLUS Registration Interest Form and turn it into our office.

Completion of the Interest form does not guarantee enrollment.

CHILD INFORMATION

Child's Name

Date of Birth

YYYY

Age

Gender

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Medical Conditions that staff should be aware of and/or that would limit your child's activities

If your child needs any medication, please indicate

Are there any specific ways we can help your child developmentally?

Is your child potty trained?

YES

Sibling Name, if applicable

Sibling Birth Date, if applicable

PARENT/GUARDIAN INFORMATION

Parent/Guardian Name

First Name

Last Name

Email Address

Cell Phone

(###)

###

####

Employer

Phone

(###)

###

####

SECOND PARENT/GUARDIAN, IF APPLICABLE

Name

Email Address

Cell Phone

(###)

###

####

Employer

Phone

(###)

###

####

Requested PLUS Program Days & Times

(A $40 fee will be charged for schedule changes.)

3's Preschool PLUS Program

PreK PLUS Program

Preferred Start Date

YYYY

Days Needed

Examples: Monday-Friday OR Mon/Wed/Fri OR Tues/Thurs, etc..

Drop-off / Pick-up Times:

Examples: 7:30am-5:00pm OR 8:30am-4:30pm OR 6:30am-6:00pm

Check Applicable Schedule

Full Day (Under 10 hrs/day)

All Day (Over 10 hrs/day)

Will your child need an afternoon nap?

Yes

Preschool & PreK PLUS Registration Interest Form

For families needing additional learning hours

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