Open Enrollment 2023-2024 MMP Application

2023-2024 Application for Open Enrollment

Submit an application for each child.
Child's Name*

First NameLast Name
Child's Class Choice

Select the class offering for your child's class. PLEASE NOTE: Class is based on the age of your child as of August 31, 2023.
Child's Enrollment: *
Student Information
Birth Date*

MonthDayYear
Date
Address*

Street Address

CityState / Province

Postal / Zip Code
Parent/Guardian Information
Mother's Name*

First NameLast Name
Cell*
Area code - Prefix - Line Number
E-mail*
Father's Name

First NameLast Name
Cell
Area code - Prefix - Line Number
E-mail
Other Infomation
Child's Doctor*
Doctor's Practice*
Is your child current on all immunizations?*

YesNo
Does your child have allergies?*

YesNo
If yes please list, including any food or drug allergies.
Does your child require any medication? If yes, please list these medications.
Does your child have any medical conditions?
Additional Information - professional evaluations or assistance (speech, developmental) to help us best serve your child.
Does your child have any siblings that are enrolling at MMP?*
Do you give permission for your family to be listed in school directory? (this will include child's name, parent's name, email, home address and phone)*
Photo Release: Do you give permission to post pictures of your child (without any name) on our social media and website?*
Would you like to learn more about Messiah Moravian Church.*
Emergency Contact - Other than Parent/Guardian

List 2 contacts who have consent to pick up from school and can be called in case of an emergency.
Full Name - 1*

First NameLast Name
Cell - 2*
Area code - Prefix - Line Number
Relation - 1*
Full Name - 2

First NameLast Name
Cell - 2
Area code - Prefix - Line Number
Relation - 2
Our Family is:*

New Family to MMPAlumni Family - our child is a sibling of a former MMP studentAlumni Parent - went to MMP as a childMessiah Moravian Church Member
COMMENTS: Any additional information that you would like to share.
Terms of Enrollment
- Registration Fee and First Month's tuition are non-refundable.
- Registration Fee of $160. This will be invoiced and drafted.
- First month's payment is due June 1, 2023
- Fees are based on the 2023-2024 school year and allows parents to pay 9 equal tuition payments.
- MMP Health Form and all necessary medical forms (e.g. Medical Action Plan) are due by August 1, 2023 (after this date there is a $15 late fee). The Health Form must show that ALL immunizations are current as of the date that the child is eligible. The completed forms must be on file in the preschool office before child can attend school.
I have submitted my child's complete information and agree to the Terms of Enrollment.
Signature*

Clear
Before you push submit

Please review all that you have submitted on the form making sure that all information is correct. We will be using the phone and/or email to contact you with your child's status with enrollment. Thank you!
Should be Empty:

2023-2024 Application for Open Enrollment

Child's Class Choice

Student Information

Parent/Guardian Information

Other Infomation

Emergency Contact - Other than Parent/Guardian

Before you push submit