Pre-K 3 Interest & Enrollment Form

Pre-K 3 Interest & Enrollment Form

Share your details and your child’s information to request enrollment for the discounted Pre-K 3 program.
Parent or Guardian Information
Parent/Guardian Full Name

First NameMiddle NameLast Name
Relationship to Child

Other
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email Address
example@example.com
Home Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Preferred Method of Contact
Child Information
Child's Full Name

First NameLast Name
Child's Date of Birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Child's Age
Is your child fully potty trained?
Has your child attended childcare, preschool, or an early learning program before?
Previous School or Childcare Center
Child’s Needs
Does your child have any allergies?
Please list all allergies and necessary precautions.
Does your child have any medical, developmental, behavioral, communication, or educational needs that we should be aware of?
Please provide additional information that will help us support your child.
What language or languages are spoken in your home?
Tell us something special about your child.
Program Interest
Why are you interested in the DVT Pre-K 3 Program?

Other
How did you hear about the program?

Other
Will your child need before-school or after-school care?
Anticipated Start Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Enrollment Acknowledgments
I understand that tuition is $500 per month.
I understand that there is a $50 nonrefundable registration fee.
I understand that my child must be fully potty trained before beginning the program.
I understand that the program hours are 8:20 a.m.–3:20 p.m.
I understand that the program operates from August 17, 2026 through May 21, 2027.
I understand that submitting this form does not guarantee placement.
I understand that enrollment is limited and spaces are filled after all required forms and fees are received.
I certify that the information submitted is accurate.
Electronic Signature of Parent/Guardian
Date Completed

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

Pre-K 3 Interest & Enrollment Form

Parent or Guardian Information

Child Information

Child’s Needs

Program Interest

Enrollment Acknowledgments