1 - Registration Form

1 Registration Form - Form 1
Hanover Church Preschool Registration Form - Form 1

Hanover Presbyterian Church - 2462 State Route 18, Clinton, PA 15026
A $35, non-refundable, registration fee must be mailed to or dropped off at the church for your registration to be considered complete. Please pay this fee in the form of check or money order payable to Hanover Church Preshool. Thank you
Class Applying For:

Preschool (T&TH) Must be 3 years old by Sept 1 (9am-11:15am) ($80/month) Pre-K (M,W&F) 4 Year Old Class (9am-12) ($115/month)
Note: Some children who turn 3 during the summer may not be ready to attend Preschool. HPC can provide guidance to assist in making decisions.
Student's Information
Child's Name

First Name Last Name
Gender

Male Female
Date

Month Day Year
Date
Name child goes by
School District you live in
Child's Mailing Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.
Parent/Guardian Email
example@example.com
Date of Birth

Month Day Year
Date
Age of child by September 1st
Name of parents or guardian your child lives with
Father's Name

First Name Last Name
Cell
Please enter a valid phone number.
Work
Please enter a valid phone number.
Address (if different than the child's)

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Mother's Name

First Name Last Name
Cell
Please enter a valid phone number.
Work
Please enter a valid phone number.
Mother's Address (if different the the child's)

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Legal Guardian's Name

First Name Last Name
Cell
Please enter a valid phone number.
Work
Please enter a valid phone number.
Legal Guardian's Address (if different than child's)

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Child's previous group experiences
How did you hear of our Preschool?
Brothers and/or Sisters
Name blanks Ageblank Birthday Date
Name blanks Age blankBirthday Date
Name blanks AgeblankBirthday Date
Should be Empty:

1 Registration Form - Form 1

Hanover Church Preschool Registration Form - Form 1

Student's Information

Brothers and/or Sisters