IAAP Information Form
Enrollment Interest
*
After-School Care Program
School of Arts Program
Child's Name
*
First Name
Last Name
Child's Date of Birth
*
-
Month
-
Day
Year
Date
Child's Gender
Female
Male
Primary Parent/Guardian Name
*
First Name
Last Name
Email Address
*
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Daytime Phone Number
*
Please enter a valid phone number.
Best Time to Contact
*
Please enter any time between 7:00 AM to 6:00 PM, Monday to Friday
Secondary Parent/Guardian Name
First Name
Last Name
Email Address
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Daytime Phone Number
Please enter a valid phone number.
Best Time to Contact
Please enter any time between 7:00 AM to 6:00 PM, Monday to Friday
Public School Attending
*
Preferred Date of Enrollment
*
-
Month
-
Day
Year
Date
How did you hear about us?
Facebook/Instagram
Google
Yelp
Other
Submit
Should be Empty: