Application Form School Year Child's Full Name * First Name Last Name Child's Nickname Age Date of Birth Gender Male Female Prefer Not to Answer Parents / Guardians Parent/Guardian Name First Name Last Name Parent/Guardian Email * Parent/Guardian Phone (###) ### #### Additional Parent Guardian Name First Name Last Name Additional Parent/Caregiver Email Additional Parent/Caregiver Phone (###) ### #### Address Address 1 Address 2 City State/Province Zip/Postal Code Country Additional Information Names and ages of siblings Child's Interests Has anyone in your family attended the school? Yes No When did they attend? Why do you want your child to attend preschool? How did you hear about the Children's Corner? Class Registration Please choose the class for which you'd like to register your child: Young 2's 2's and 3's 3's and 4's Pre-K Thank you!
