Student's Name
*
Parent's Name
*
Phone Number
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-
Area Code
Phone Number
E-mail
*
Class
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Preschool Red
Preschool Yellow
Pre-K Red
Pre-K Blue
Cost
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Preschool Tuition
$
133.00
Preschool LATE
$
148.00
Pre-K
$
153.00
Pre-K Tuition - LATE
$
168.00
Credit Card
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
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