Trinity Preschool Enrollment Form
Parent / Guardian Information
Full Name
Relation to Child(ren)
Cell Phone
-
Area Code
Phone Number
Work Phone
-
Area Code
Phone Number
Email
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Second Parent / Guardian Name
Relation to Child(ren)
Cell Phone
-
Area Code
Phone Number
Work Phone
-
Area Code
Phone Number
Email
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
1st Child
Child Full Name
Gender
Male
Female
Date of Birth
-
Month
-
Day
Year
Date
Child's Age
Potty-Trained?
Yes
No
Please any food or medication allergies:
Please list any additional pertinent information:
2nd Child
Child Full Name
Gender
Male
Female
Date of Birth
-
Month
-
Day
Year
Date
Child's Age
Potty-Trained?
Yes
No
Please any food or medication allergies:
Please list any additional pertinent information:
3rd Child
Child Full Name
Gender
Male
Female
Date of Birth
-
Month
-
Day
Year
Date
Child's Age
Potty-Trained?
Yes
No
Please any food or medication allergies:
Please list any additional pertinent information:
Has your child / have your children been in a child-care program before?
Yes
No
If so, where?
How did you hear about Trinity Preschool?
I would like my child(ren) to start by:
-
Month
-
Day
Year
Date
I am interested in:
Monday - Friday Full Time
Monday / Wednesday / Friday Part Time (2-4 year olds only)
Tuesday / Thursday Part Time (2-4 year olds only)
Type name of parent / guardian filling out this form:
Parent / Guardian Signature
Today's Date
-
Month
-
Day
Year
Date
Submit
Should be Empty: