Preschool Registration

First Presbyterian Christian Preschool Waiting List
Thank you for your interest in our childcare program. This form along with a $25 non-refundable fee (check) must be received in our office in order for you to be placed on our waiting list. If you have any questions or would like to visit our center, please feel free to contact us at fpcccdirector@fpcstarkville.org or 662-324-0726. We will do everything possible to place your child in our center as quickly as possible according to your requested care date.

Please make your check payable to:

First Presbyterian Church Child Care

307 University Drive

Starkville, MS 39759
Preschool Registration
Expected Start Date

MonthDayYear
Student Information
First Name*
Last Name*
Gender*

FemaleMaleUnknown
Birth or Due Date*

MonthDayYear
Parent/Guardian Information 1
Full Name*

First NameLast Name
Cell

Area CodePhone Number
Work

Area CodePhone Number
E-mail*
Address - Same As Child*

YesNo
If your address is different than the childs please fill out the info below. Otherwise move onto the next section.
Parent/Guardian 1 Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent/Guardian Information 2
Full Name

First NameLast Name
Cell

Area CodePhone Number
Work

Area CodePhone Number
E-mail
Address - Same As Childs

YesNo
If your address is different than the childs please fill out the info below. Otherwise move onto the next section.
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
All registrations are received and reviewed in a first come, first serve basis. Upon filling all open spots, all additional submissions will be added to our waiting list.
Should be Empty:

First Presbyterian Christian Preschool Waiting List

Preschool Registration

Student Information

Parent/Guardian Information 1

Parent/Guardian Information 2