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Alphabet Kids Academy
Pre-Enrollment Form
Are you enrolling multiple children?
Yes
No
Child's Information
Child's Name
*
First Name
Middle Name
Last Name
Date of Birth
*
-
Month
-
Day
Year
Date
Gender
*
Female
Male
2nd Child's Name
First Name
Middle Name
Last Name
Date of Birth
-
Month
-
Day
Year
Date
Gender
Female
Male
3rd Child's Name
First Name
Middle Name
Last Name
Date of Birth
-
Month
-
Day
Year
Date
Gender
Female
Male
Home Phone
*
Please enter a valid phone number.
Format: (000) 000-0000.
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Preschool Attendance Information
Expected Start Date
*
-
Month
-
Day
Year
Date
Attendance Days
*
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
From
*
Hour Minutes
AM
PM
AM/PM Option
To
*
Hour Minutes
AM
PM
AM/PM Option
Parents/Guardian & Emergency Contact Information
Parent/Guardian
*
First Name
Last Name
Email
*
example@example.com
Relationship
*
Mother, Father, etc
Mobile Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Work Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Address
*
Same with the child
Different Address
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Emergency Contact
*
First Name
Last Name
Email
*
example@example.com
Relationship
*
Mother, Father, etc.
Mobile Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Work Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Address
*
Same with the child
Different Address
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Submit
Should be Empty: