Excel Christian Preschool Student Application

Excel Christian Preschool Student Application

Please complete the form to apply for preschool enrollment.
STUDENT / FAMILY INFORMATION
Name of Child*

First NameLast Name
Age*
Birthdate*

MonthDayYear
Date
Parent/Guardian 1 Name*

First NameLast Name
Parent/Guardian 1 Address*

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Parent/Guardian 1 Phone*
Please enter a valid phone number.Format: (000) 000-0000.
Parent/Guardian 1 Email*
example@example.com
Parent/Guardian 2 Name*

First NameLast Name
Parent/Guardian 2 Address*

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Parent/Guardian 2 Phone*
Please enter a valid phone number.Format: (000) 000-0000.
Parent/Guardian 2 Email*
example@example.com
Getting to Know You

Please share a little more about your child and family background.
Tell us about your child in a few sentences - what do they like, what are their favorite songs, foods, toys*
YesNo
Name of the center
Address of the center*

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Phone number of the center*
Please enter a valid phone number.Format: (000) 000-0000.
Email of the center*
example@example.com
Has your child been evaluated for medical or social/emotional needs? Please list details - write N/A if your child has never had any evaluations or concerns*
Please tell us about any allergies we need to be aware of - write N/A if none*
Please list any medications your child takes that we need to be aware of - write N/A if none*
YesNo
Please provide details. Write N/A if the answer was no.*
Why did you choose Excel as an option for your child?*
Where do you attend?*
Please upload your child's birth certificate, immunization record and annual physical. *

Cancelof
If your child receives a voucher from ELC - School Readiness - please upload the certficiate.

Cancelof
I will pay the non-refundable application fee of $75.00.
https://square.link/u/UG7NOnnQ
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Excel Christian Preschool Student Application

STUDENT / FAMILY INFORMATION

Getting to Know You