Weekday School Interest Form

Interest Form

Fill out the form carefully for registration
Parent 1*

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent 2*

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Is your child currently enrolled, previously enrolled, or a newcomer to UCUMC Weekday School?*

Currently EnrolledPreviously EnrolledNewcomer
How many children are you applying for?

Student Information
Name*

First NameLast Name
Gender*

MaleFemale
Birthday*

MonthDayYear
Date
Previous Preschool/Daycare
Allergies:
Developmental Delays:
Speech/OT Services:
Potty Trained?*

YesNoWorking
Extended Day?*

YesNo
First Class Choice (Toddler Classes)*
Second Class Choice Class Choice (Toddler Classes)*
First Class Choice (2's Classes)*
Second Class Choice Class Choice (2's Classes)*
First Class Choice (3's Classes)*
Second Class Choice Class Choice (3's Classes)*
First Class Choice (4's Classes)*
Second Class Choice Class Choice (4's Classes)*
Transitional Kindergarten*

Thank you for your interest in UCUMC Weekday School.

Unfortunately, your child is too young to attend UCUMC Weekday School. Please contact us @ 704.369.8009 with any questions.

Student Information
Name*

First NameLast Name
Gender*

MaleFemale
Birthday*

MonthDayYear
Date
Previous Preschool/Daycare
Allergies:
Developmental Delays:
Speech/OT Services:
Potty Trained?*

YesNoWorking
Extended Day?

YesNo
First Class Choice (Toddler Classes)*
Second Class Choice Class Choice (Toddler Classes)*
First Class Choice (2's Classes)*
Second Class Choice Class Choice (2's Classes)*
First Class Choice (3's Classes)*
Second Class Choice Class Choice (3's Classes)*
First Class Choice (4's Classes)*
Second Class Choice Class Choice (4's Classes)*
Transitional Kindergarten*

I verify the information provided is correct.
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