St. Paul's Mommy & Me Application Form

Application for:

Mommy & Me (Fridays 9:30 – 11 a.m.)

Please fill out the form as completely as possible.

St. Paul's Preschool Mommy & Me Application

Enrollment Application for St. Paul's Mommy & Me Program I understand that a teacher will be present to guide and nurture my child, and introduce developmentally supportive activities. I will be present at all times to supervise and guide my child during Mommy & Me. I understand that a non-refundable enrollment fee of $25 must be received to hold my child's place on the roster.

Child's Full Name(Required)

First Last

Date of Birth(Required)

Gender(Required)

Male

Female

Parent Name(Required)

First Last

Parent Phone(Required)

Parent Email(Required)

Current Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Special Medical Concerns/Allergies

How did you learn about St. Paul's Preschoo Mommy & Me

Church member

Sibling in Preschool

Website

Friend/Family Recommendation