Application for Enrollment

---

Please fill out the form below to apply. If you are interested in printing the enrollment form and mailing it in, you can download the PDF forms here:

• Toddler/Preschool Program form
• After School program form
• Summer Camp form

Online Application for Enrollment Form

---

Child Information

Name of Child(Required)

Date of Birth(Required)

MM slash DD slash YYYY

Sex(Required)

Male

Female

Address(Required)

Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code

Is your child currently enrolled in school? If so please tell us which school:

Parent/Guardian Information

Name(Required)

Email(Required)

Phone Number 1(Required)

Phone Number 2

Address

Same as child's address

Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code

Add additional parent/guardian information?(Required)

Yes

No

Name(Required)

Email(Required)

Phone Number 1(Required)

Phone Number 2

Address

Same as child's address?

Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code

Enrollment Information

How did you hear about us?

Online search

Friend

Alumni

Organization/School

Other

Name of person or organization who referred you:

Desired Date of Enrollment(Required)

MM slash DD slash YYYY

I wish my child to be enrolled in:(Required)

Toddler/Preschool Program

After School Program

Summer Camp

Toddler/Preschool Program - Select full time or part time(Required)

Full Time - Mon thru Fri (8:00 AM - 6:00 PM)

Part Time - Select days

Toddler/Preschool Program - Select Days(Required)

MondayTuesdayWednesdayThursdayFriday

Toddler/Preschool Program - Select Time(Required)

8:00 AM - 12:30 PM8:00 AM - 1:00 PM8:00 AM - 3:00 PM8:00 AM - 6:00 PM1:00 PM - 6:00 PM

After School Program - Select full time or part time(Required)

Full Time - Mon thru Fri (3:00 PM - 6:00 PM)

Part Time - Select days

After School Program - Select Days(Required)

MondayTuesdayWednesdayThursdayFriday

After School Program - Select Times(Required)

3:00 PM - 6:00 PM

Summer Camp - Select full time or part time(Required)

Full Time - Mon thru Fri (8:00 AM - 6:00 PM)

Part Time - Select days

Summer Camp - Select Days(Required)

MondayTuesdayWednesdayThursdayFriday

Summer Camp - Select Time(Required)

8:00 AM - 12:30 PM8:00 AM - 1:00 PM8:00 AM - 3:00 PM8:00 AM - 6:00 PM1:00 PM - 6:00 PM

Tour Date

MM slash DD slash YYYY

Parent/Guardian Signature(Required)

Application Fee

Application Fee(Required)

Note: The application fee is non-refundable.

Fee:

Billing Address(Required)

Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code

Credit Card(Required)

Card Details

Cardholder Name