Crab Orchard Baptist Preschool Application Form 2025-2026

Crab Orchard Baptist Preschool

Application form (2025-2026) school year)
STUDENT NAME*

Student First NameStudent Middle NameStudent Last Name
Birth Date*

MonthDayYear
Gender
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent Information*

Father's First NameFather's Last Name
Address if different:
Father's phone to be used during preschool hours:*
Parent Information*

Mother's First NameMother's Last Name
Email address:
Address if different:
Mother's phone to be used during preschool hours:*
Mother's E-mail*
example@example.com
Martial Status: blanks
If separated or divorced, with whom does the child reside?
Primary Parent Mobile Number*
Work Number if applicable
Employer
Father
Employer
Mother
Class Information*
*Playgroup classes are FULL-please call for more information. Please select the class you are interested in for your child. *Middler and PreK class must be potty trained. Playgroup: Child must be age 2 by July 1. Middler: Child must be age 3 by July 1. PreK: Child must be age 4 by July 1.
Behavior/Medical Information
Child's Physician
Allergies
Medical conditions or allergies
Has your child ever been enrolled in another preschool/daycare? If yes, explain reason for leaving:*
Does your child exhibit any behavioral, cognitive, or verbal difficulties? If yes, please explain:*
Has your child ever been enrolled with a Birth-3 program or is currently enrolled? If so, explain:*
NOTE:

Our 2025-2026 school year will begin on September 2, 2025
Additional Comments

Registration Fee*

USDRegistration Fee, this fee must be paid to secure your child's spot for the 2023-2024 school year

Credit Card

Crab Orchard Baptist Preschool

Application Form (2025-2026)
Date

MonthDayYear
Date
Should be Empty:

Crab Orchard Baptist Preschool

NOTE:

Credit Card

Crab Orchard Baptist Preschool