Registration Form
 director@oursaviorpreschool.com

 

Applying for ___ 3 Year Old (3 day) ____ 3 Year Old (5 day) ____ 4 Year Old (3 day) ____ 4 Year Old (5 day)

 

To enroll in the Three Year Program the child must be 3 by September 10th ALL CHILDREN MUST BE TOILET

To enroll in the Four Year Program the child must be 4 by September 10th TRAINED TO ATTEND PRESCHOOL

 

 

General Information

 

Name of Child: _________________________ Name Used at Home____________________

 

Birthdate: __/__/__ Present Age ______ Sex: ___M ___F Phone Number _______________

 

Address________________________________________________________________________

 

E-MAIL ADDRESS:_______________________________________________

 

Parents are: Married____ Separated____ Divorced ____ Adoptive Parent ____ Grandparent____

 

Names of other children in family:

 

Name: __________________________________________ Birthdate: __/__/__

 

Name: _________________________________________ Birthdate: __/__/__

 

Name: _________________________________________ Birthdate: __/__/__

 

 

Full name of Mother:_________________________________________ Cell Phone:_________________

 

Address:_________________________________________________ Home Phone:__________________

 

Place of work:_____________________ Address:_____________________ Work Phone:_____________

 

Full name of Father:_________________________________________ Cell Phone:_________________

 

Address:_________________________________________________ Home Phone:__________________

 

Place of work:_____________________ Address:_____________________ Work Phone:_____________

 

 

 

Church you attend: ______________________ If nonmember, give church preference_______________