Online Enrollment Session * 2025-2026 2026-2027 Program * 3 full days (8am-3pm) 4 full days (8am-3pm) 5 full days (8am-3pm) Preferred Days If you are choosing a 3 or 4 day option, please list your preferred days and we will do our best to accommodate them. CHILD Child Name * First Name Last Name Birth Date * MM DD YYYY Gender M F Child's Race/Ethnicity * Check All that Apply American Indian or Alaska Native Asian Black or African American Hispanic or Latino Native Hawaiian or Other Pacific Islander White After School Care We have a limited amount of after school care slots from 3 to 5 pm. Please list days and times that you are interested in. Parent / Guardian 1 Name * First Name Last Name Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Home Phone * (###) ### #### Mobile Phone (###) ### #### Work Phone (###) ### #### Parent 1 mail * Parent / Guardian 2 Name First Name Last Name Address Address 1 Address 2 City State/Province Zip/Postal Code Country Home Phone * (###) ### #### Mobile Phone (###) ### #### Work Phone (###) ### #### Background information Siblings * How did you hear about us? * Previous Schools * Please list every school that your child has attended Educational Goals What are your educational goals for your child? How do you see us facilitating these goals? Hobbies & interests Does your child have any hobbies, sports, or special interests, capabilities or talents? Social/emotional development How do you see your child in their social and emotional development? Special Help And Encouragement Are there any areas in which we may be able to give special help and encouragement to your child? Non-Discrimination Policy We value diversity among our students. We do not discriminate in our enrollment policies on the basis of race, color, gender, religion, sexual orientation, national or ethnic origin. Scholarship * Are you interested in applying for a tuition scholarship? We prioritize scholarships based on financial need. Yes No Thank you!
