(413) 362-1610/1600
Enrollment Application
Child’s Full Name:
________________________________________________________
Date of Birth: _____________ Age by September 1st
_____________ Gender: __________
Parent(s)/Guardian(s) Name(s):
______________________________________________
Address:
______________________________________________________________
Phone Number(s):
________________________________________________________
|
Please check off the program(s) you are
applying for: ___
5 mornings per week ___ 4 mornings
per week ___ 2 afternoons per week |
Please describe previous daycare or school
experiences:
Describe your child briefly:
Please identify any questions that you may
have about the program:
Please return this application to
Janet Ryan by February 15th.
Students will tentatively be selected in the last week of February and
written notification will be mailed to parents/guardians in the first week of
March.
Ms. Janet Ryan, Early Education Coordinator
Note: Children must be a minimum
of at least three years old on or before September 1st, 2007 to be
considered for the