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Preschool Admission Form - Mountain House
CHILD INFORMATION
Name *
DOB *
Address *
MOTHER'S INFORMATION
Name *
Email *
Phone *
FATHER'S INFORMATION
Name *
Email *
Phone *
WHO WILL PICKUP CHILD FROM CENTER
Name *
Email
Phone
EMERGENCY CONTACT
Name *
Phone *
Special Comments
How did you hear about us
PROGRAM DETAILS
Choose your program *
--Select Program--
Preschool Half Day Program: 8:15am-11:30am
Preschool Extended Care Program: 8:00am-2:30pm
Preschool Full Day Program 8:00am-6:00pm
Preschool Pm Program: 2:45pm-5:45pm
Extended Hrs Mrn 7:30am - 8:30am
Extended Hrs Eve 6:00pm - 7:00pm
Choose number of days in a week *
--Select Days--
4 days
5 days
Choose your payment terms *
One time Registration/Material Fees (non-refundable): $125
--Select Payment Terms--
Monthly
5 Months [5% Discount]
10 Months [10% Discount]
Submit
