APPLICATION FOR 2009-2010 SCHOOL YEAR
ALL GOD’S CHILDREN EARLY LEARNING CENTER
Date of Birth___________________________Phone______________________________
Home Address________________________________City______________Zip________
Father’s Name_________________________Occupation__________________________
Business Address______________________ Business Phone_______________________
Mother’s Name________________________Occupation___________________________
Business Address______________________ Business Phone_______________________
Parent e-mail address for teacher use and preschool information _____________________
Parent’s Marital Status: Single / / Married / / Separated / / Divorced / /
Other children in family:
Name________________________________ Birthdate_________
Name________________________________ Birthdate_________
Name________________________________ Birthdate_________
Name________________________________ Birthdate_________
Parent’s Church Affiliation___________________________________
*A deposit equivalent to one month’s tuition ($100 for M-W-F and $75 for T-Th) is required
with application for enrollment. Your deposit is non-refundable after July 1st, 2009.
This deposit will be used to pay your last month’s tuition- May 2010.
Please return this form as soon as possible. You will be notified by mail of your child’s admittance.
Please check all that apply:
_____ My child is a returning student who is currently enrolled
_____ I am a member of the Lutheran Church of Mahomet
_____ My child is a previously enrolled student
_____ My child is the sibling of a currently enrolled student
_____ My child is the sibling of a previously enrolled student
_____ Our family will be new to the program.
_____ My child is potty-trained
_____ My child is not yet potty-trained. I understand that my child must be potty-trained
before September 1, 2009 to be enrolled in All God’s Children Early Learning Center.
Applying for:
T -Th 3-4 class FULL Mornings (9-11:30) ______ Afternoons (12:30-3)
M W F Pre-K class FULL Mornings (9-11:30) _FULL Afternoons (12:30-3)
Signature of Parent:_________________________________________ Date:______________