Enrollment Inquiry

Initial Request for Preschool Programs

This will begin the enrollment process. Acceptance happens mid-June based on application review for program eligibility.

Parent First Name Please provide the first name of one parent

Parent Last Name Please provide your last name

Street Address

City

State

Zip Code

Phone 1

Phone 2

_____________________________________________________________________________________________

Please answer the following about your child:

Child's First name Name is required

Child's Last name This is required

Child's DOB

Preferred Classroom Location Please choose the preferred classroom you would like your child to attend.

Secondary Classroom Location Please choose a secondary classroom if your student is unable to attend your preferred classroom location. *NOT REQUIRED

Are you currently receiving food assistance (SNAP)? (required) Yes No

Kalee Coss

Enrollment Coordinator

231-592-9605