2024-2025 A Child's Place
10 Month Application
TWOS, THREES AND FOURS
New Student
Child's Name
First Name
Last Name
Date of Birth
/
Month
/
Day
Year
Date
Today's Date
*
-
Month
-
Day
Year
Date
WAITLIST STATUS - As of November 9, 2023
Status of Applicant
Sibling of currently enrolled child(ren) - Due October 16, 2023
Alumni child at ACP - Due October 18, 2023
23-24 Waitlist Children - Due October 20, 2023
Community applicant - Due October 23, 2023
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Primary Contact/Guardian:
First Name
Last Name
Phone 1
Phone Type 1
Please Select
Cell
Home
Work
Email 1
example@example.com
Relationship to Child 1
Phone
Secondary Contact/Guardian"
First Name
Last Name
Phone 2
Please Select
Cell
Home
Email 2
example@example.com
Relationship to Child 2
Program Interested In:
Program Interested in:
Twos Program - 2 years by 9/1/24 - Waitlist Only
Twos Extended Day
Threes Program - 3 years by 9/1/24 - Waitlist Only
Threes Extended Day
Fours Program - 4 years by 9/1/24 - Waitlist Only
Fours Extended Day
TWOS MON/WED/FRI (9:00 - 12:30) INDICATE 1ST OR 2ND CHOICE
TWOS TUES/THURS (9:00 - 12:30) INDICATE 1ST OR 2ND CHOICE
THREES MON/WED/FRI (8:45 - 1:00) INDICATE 1ST OR 2ND CHOICE
THREES MON - FRI (8:45 - 1:00) INDICATE 1ST OR 2ND CHOICE
Fours Program - 4 years by 9/1/23
FIVE MORNINGS (8:45 - 1:30)
4S EXTENDED PLAY (1:30 - 3:15)
Desired Extended Days - 2s
MONDAY
TUESDAY
WEDNESDAY
THURSDAY
FRIDAY
Desired Extended Days - 3s
MONDAY
TUESDAY
WEDNESDAY
THURSDAY
FRIDAY
Desired Extended Days - 4s
MONDAY
TUESDAY
WEDNESDAY
THURSDAY
FRIDAY
Signed
*
Date
*
/
Month
/
Day
Year
Date
Submit and add additional child if needed
Should be Empty: