Registration Form

Schedule Tour/Pre-Registration Form

Thank you for your interest in Little Dreamers Academy!
Please fill out this pre-registration/tour request form to be considered for one of our toddler or school aged full and part time spaces. After this form is submitted, we will contact you to schedule an interview/tour to meet your lovely family! We will discuss your childcare needs and our philosophy. Space is limited so don't delay!
Parent #1 Name*

First NameLast Name
Parent #2 Name

First NameLast Name
Child's Name*

First NameMiddle NameLast Name
Child's Birth Date*

MonthDayYear
Child's Gender
Second Child

First NameMiddle NameLast Name
Child's Birth Date

MonthDayYear
Child's Gender
Address*

Street Address

Street Address Line 2

CityState

Zip Code
Primary E-mail*
Secondary E-mail
(optional)
Date requested for Tour of the Academy

MonthDayYear
Date
Preferred Start Date
Parent #1 Primary Phone Number

Area CodePhone Number
Parent #2 Primary Phone Number

Area CodePhone Number
Preferred Care Schedule*
Additional Comments
If not full-time, please indicate preferred schedule.
Should be Empty:

Schedule Tour/Pre-Registration Form