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Application Form
To apply, please take the time to fill out the information below.
Child's First Name
Child's Last Name
Child's Birthday
Child's Gender
Child's Doctor's Name
Doctor's Phone #
Child's AHC#
Are all Immunizations up to date?
*
Yes
No
Does your child have any medical or emotional conditions requiring treatment or supervision?
*
Yes
No
Class Preferance
*
2 Day - Morning Program for 3 Year Olds
2 Day - Afternoon Program for 3 Year Olds
RSG Artisans Program for 4 and 5 Year Olds
3 Day - Morning Program for 4 Year Olds
4 Day - Afternoon Program for 3-5 Year Olds
Does your child have previous Preschool/Playschool experience?
*
Yes
No
Language spoken at home:
Other siblings? If so, their ages:
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