West St Paul Nursery School Renewal Registration

West St Paul Nursery School Renewal Form
All registrations are received and reviewed on a first-come, first-serve basis. Upon filling all open spots, all additional submissions will be added to our waiting list.
School Year?*
First Class choice*

TUES/THURS - AMM/W/F - PMM/W/F - AMTUES/THUR - PM - upon availability
Second Class choice*

TUES/THURS - AMM/W/F - PMM/W/F - AMTUES/THUR - PM - upon availability

Caregiver Information 1
Caregiver 1 Full Name*

First NameLast Name
Caregiver 1 Relationship*

MotherFather
Caregiver 1 Home phone
Caregiver 1 Cellphone*
Caregiver 1 E-mail*
Caregiver 1 Place of Employment*
Caregiver 1 Occupation*
Caregiver 1 Work Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Caregiver 1 Work Phone Number*
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.
Caregiver 1 Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Caregiver Information 2
Caregiver 2 Full Name*

First NameLast Name
Caregiver 2 Relationship

MotherFather
Caregiver 2 Home phone
Caregiver 2 Cellphone*
Caregiver 2 E-mail
Caregiver 2 Place of Employment*
Caregiver 2 Occupation*
Caregiver 2 Work Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Caregiver 2 Work Phone Number*
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.
Caregiver 2 Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Emergency Contact
Name*

First NameLast Name
Relationship*
Home Number*
Cell Number*
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.
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West St Paul Nursery School Renewal Form