Gorham House Preschool Registration Form

Gorham House Preschool Registration Form
Todays Date:

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Child's Name:
Date of Birth:

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Home Address:
Parent 1/Legal Guardian Name:
Home Address:
Phone Number:
Format: (000) 000-0000.
Email:
example@example.com
Parent 2/Legal Guardian Name:
Home Address:
Email:
example@example.com
Desired Start Date:
(Example: Fall 2027)
Desired Program:
(Example: Half Day/Full Day)
Desired Schedule:
(Example: Monday/Wednesday/Friday, Tuesday/Thursday, Monday-Friday)
(Child must be 3 years of age on or before July 1st for Summer Session and on or before September 1st for Fall Session)

To secure enrollment, completing this Preschool Registration Form is required. If immediate enrollment is not available, your completed Registration Form will automatically place your child on the waitlist for your requested enrollment year. If an enrollment spot is available and enrollment has been confirmed, a $25.00 non- refundable enrollment fee will be required along with your first month's tuition payment. A binding service agreement will be subject to the execution of a Preschool Service Agreement upon enrollment.
Parent Name:
Parent Signature:
Date:

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Should be Empty: