Pre-Application Application Date: Requested Start Date: Child's Information: Child's Age Child's Birth Date Gender---MaleFemale Parent's Name Parent's Address Cell Phone Cell Phone Carrier Home Phone Email Place of Employment Business Phone Parent's Name Parent's Address Cell Phone Cell Phone Carrier Home Phone Email Place of Employment Business Phone Applying to:Infants (6 weeks to 18 months)Toddlers (18 months to 3 years)Primary (3 - 6 years)Lower Elementary (6 - 9 years)Upper Elementary (9 - 12 years) I understand the below information: Application Fee: $150 (one time only and non-refundable) Note: Enrollment requires $100 annual enrollment fee. Receipt of this form does not guarantee enrollment. Enrollment will be confirmed based on classroom space, requested start date and prior applications. Enrollment status will be advised within 10 days of receipt of application. Please note that should you decline to enroll when offered your desired start date, you will be removed from the wait list and must reapply. My initials will stand as my signature for this form: Δ