Clone of Little Learning 2021/2022 Admissions Application

Little Learning Admissions Application

4 E. 81st Street, New York, NY 10028 | (917) 675-6837

www.littlelearning.com | admissions@littlelearning.com

Student Full Name

First NameLast Name

Student Nickname (if applicable)

Student Date of Birth

MonthDayYear

Student Gender

Parent Name #1

First NameLast Name

E-mail

example@example.com

Parent Name #2

First NameLast Name

E-mail

Home Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Home Number

Area CodePhone Number

Mobile Number

Area CodePhone Number

Who referred you to Little Learning?

Why would you like your child to attend Little Learning?

How would you describe your child (personality, interests)?

Please specify which preschool your child will be attending for the academic year. If not applicable, please put 'N/A'.

Below, please write the days and specific times (start & end) that your child will attend pre-school. (Please write "unsure" if you do not know your schedule yet, or 'N/A' if not applicable).

Do you anticipate your child requiring a nap?

Please note which Little Learning Program you wish to enroll in.

If your child will require a nap, please specify start and end times.

Please specify if there are children with whom you would like your child to be in class. Please note: we cannot guarantee all requests.

Admission Application Processing Fee

Admission Application Processing Fee$50.00

Debit or Credit Card
First Name	Last Name
Credit Card Number	Security Code
Expiration Month	Expiration Year

Admission Application Processing Fee*

Admission Application Processing Fee