Enrollment Application – 6411 Fleet Street Rego Park, NY 11374

Step 1 of 2

MM slash DD slash YYYY
CLASSROOM: 2-3

CHILD’S INFORMATION

Full Name
MM slash DD slash YYYY
Address

PARENT’S INFORMATION

Mother’s Name
Father’s Name
Has your child been enrolled in another school before?
Does your child have any allergies?
Can we photograph your child to use for classroom projects, ClassDojo and/or our social media pages?

Relatives or Friends phone # to contact in case of an emergency

Name
Name
Attending Days