Preschool Initial Enrollment Form

Preschool Initial Enrollment Form

ATTENTION this is an initial application to register it does not confirm enrollment Notably Gifted Arts Academy is Christian Preschool for students ages 2.5-5years (not eligible for kindergarten) We are a full time program meaning students must attend 4-5 full days Academic instruction: 8:00am-3:00pm M-TH Friday 8am-1:30pm Our program will begin September 8, 2026- May 21, 2027 Tours can be scheduled by texting tour request 937-985-3703 or schedule online We are located at 2800 E River Road Dayton, OH 45439 we do not provide transportation. We accept private pay, Publicly Funded Child Care (Title XX) and Preschool Promise Once you complete this initial application we will contact you and will provide an enrollment link and schedule a parent/child interview. Once the enrollment is accepted a $75 registration fee will be assessed website: www.ngaapreschool.org PFCC link: http://ssp.benefits.ohio.gov/
Child's Full Name

First NameLast Name
Child's Date of Birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Parent/Guardian Full Name

First NameLast Name
Parent/Guardian Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Parent/Guardian Email Address
example@example.com
Home Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Emergency Contact Name

First NameLast Name
Emergency Contact Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
List any allergies, medical conditions, or special needs
Is your child fully potty trained? (can use the potty unassisted)
Do you have PFCC/title 20 http://ssp.benefits.ohio.gov/
Do you have Preschool Promise Dohttps://www.preschoolpromise.org/
Should be Empty: