LIP Re-Enrollment Form 2023-24
Please complete by April 15, 2023
Do you plan to continue your child's enrollment for the 2023-24 school year?
*
Yes
No
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Please share why you do not plan to continue enrollment for the 2023-24 school year?
Please Select
Enrolling in TK
School hours
Not happy with LIP curriculum
Moving out of the area
Enrolling at in different a different childcare program
Other
Child's Name
First Name
Last Name
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Child's Name
*
First Name
Last Name
Child's Date of Birth
*
-
Month
-
Day
Year
Date
Home Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Program Information
Do you want to change the current schedule?
*
Yes
No
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Which program are you interested in?
Full Time (5 days)
Part Time (3 days)
Which hours are you interested in?
Extended Day Hours: 7:30am - 5:00pm
Full Day Hours: 9:00am - 4:00pm
Half Day Hours: 8:00am - NOON
Which days of the week are you interested in?
*
Monday
Tuesday
Wednesday
Thursday
Friday
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Parent/Guardian 1 Name
*
First Name
Last Name
Contact Info for Parent/Guardian 1 provided is
*
Same as 2021-2022
Changed from 2021-2022
Parent/Guardian 1 Cell Phone
Please enter a valid phone number.
Parent/Guardian 1 Email
example@example.com
Parent/Guardian 1 Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Parent/Guardian 1 Employer
Parent/Guardian 2 Name
First Name
Last Name
Contact info for Parent/Guardian 2 provided is
Same as 2021-2022
Changed from 2021-2022
Parent/Guardian 2 Cell Phone
Please enter a valid phone number.
Parent/Guardian 2 Email
example@example.com
Parent/Guardian 2 Address (if different than Parent/Guardian 1)
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Parent/Guardian 2 Employer
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Submit
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