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Registrationform 2017

This registration form is for Emmanuel Lutheran Preschool for the 2017-2018 school year. It collects contact information for the child and parents, including name, address, phone numbers, birthdate, church affiliation, and any special needs. Parents can select their preferred morning class for either 2, 3, or 4 days per week for 3-4 year olds. The form must be returned with a $45 non-refundable registration fee.

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62 views1 page

Registrationform 2017

This registration form is for Emmanuel Lutheran Preschool for the 2017-2018 school year. It collects contact information for the child and parents, including name, address, phone numbers, birthdate, church affiliation, and any special needs. Parents can select their preferred morning class for either 2, 3, or 4 days per week for 3-4 year olds. The form must be returned with a $45 non-refundable registration fee.

Uploaded by

api-375316987
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Date _______________________________

REGISTRATION FORM 2017-2018


EMMANUEL LUTHERAN PRESCHOOL
Name of Child ________________________________________ Sex ______________________
Name you would like your child to print: _________________________________________________
Address ________________________________________ City/ Zip Code ___________________
Email Address_____________________________________ Home Phone ___________________
Birth Date _______________________________________ Age ____________________
Fathers Name ____________________________________________ Cell Number _______________
Place of Employment ________________________________ Phone __________________
Mothers Name ___________________________________________ Cell Number _______________
Place of Employment ________________________________ Phone __________________
Other children in your family & ages______________________________________________________
Church Affiliation _____________________________________________________________________
Any special problems the staff should know _______________________________________________

Please Check Class Preference:


Select a 1st choice and 2nd choice.
Availability on Total Number of Children Enrolled

Monday/Wednesday Morning (3s) 9:30 12:00 _____________________________


Tuesday/Thursday Morning (3s) 9:30 12:00 _____________________________
Mon./Tues./Wed. Morning (4s) 9:30 - 12:00 ____________________________

Mon./Tues./Wed./Thurs. Morning (4s) 9:30 12:00 _____________________________

Notes on Class Preference: _____________________________________________________

____________________________________________________________________________

PLEASE FILL OUT AND RETURN IMMEDIATELY WITH $45.00 REGISTRATION FEE (NON-REFUNDABLE)
TO: EMMANUEL LUTHERAN PRESCHOOL OFFICE USE ONLY
360 PRINCETON AVENUE
ELYRIA, OH 44035 _________________
CHECK OUR WEBSITE: www.elc-elyria.org

2-day $95.00 3-day - $145.00 4-day $ 190.00


Emmanuel Lutheran Pre-School admits students of any race, color, national and ethnic origin to all the rights, privileges,
programs, and activities generally accorded or made available to students at the school. It does not discriminate on the basis of
race, color, national and ethnic origin in administration of its educational policies, admissions policies, and athletic and other
school-administered programs.

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