Application for Enrollment (Online) Application Child's Last Name*Child's First Name*Child's Birthdate* MM DD YYYY Child's Gender Female Male Parent/Guardian #1 Last Name*Parent/Guardian #1 First Name*Parent/Guardian #1 Email* Parent/Guardian #1 Cell Phone*Parent/Guardian #2 Last Name*Parent/Guardian #2 First Name*Parent/Guardian #2 Email* Parent/Guardian #2 Cell Phone*Home Address* Street Address City State / Province / Region ZIP / Postal Code Allergies or Food Restrictions (or note None)*Does your child have an Epipen?* Yes No Is there any medical or other condition we should know about?Desired Start Date*This start date is not guaranteed if you are on the waitlistRequested Program* Preschool (2.9 years and older + toilet-trained) Toddler (18 months - 3 years + confident walker) Preschool/K Requested Schedule (select a program that covers your expected schedule)* Half Day (8:30am-11:30am) Half Day + Before Care (7:30am-11:30am) Academic Day (8:30am-3:15pm) Academic Day + Before Care (7:30am-3:15pm) Academic Day + After Care (8:30am-6:00pm) Academic Day + Before Care + After Care (7:30am-6:00pm) Toddler Requested Schedule (select a program that covers your expected schedule)* Half Day (8:30am-11:30am) Academic Day (8:30am-3:15pm) Academic Day + Before Care (7:30am-3:15pm) Academic Day + After Care (8:30am-6:00pm) Academic Day + Before Care + After Care (7:30am-6:00pm) How many days per week are you interested in?* 3 4 5 If you selected less than 5 days, please indicate which days you're requesting your child to attend. We highly recommend those days be consecutive (M/T/W, T/W/Th, W/Th/F) Mondays Tuesdays Wednesdays Thursdays Fridays What school district or private school will your child likely attend? (Bloomfield, Birmingham, Country Day, St. Hugo, etc)Is your child toilet-trained?* Yes No Almost - we're working on it Is your toddler a confident walker?* Yes No Tuition updates* I understand the tuition rates given at our tour may not reflect the tuition rates at the time of enrollment.Please request an updated price sheet if you were on the waitlist for a significant amount of time.
