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Childcare/Preschool Interest Form
Please fill out this form if you are interested in childcare or preschool here at St. John's. If you are ready to sign up your child, please fill out the registration form located on the website.
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* Indicates required question
Child's Full Name (first, middle initial, last)
*
Your answer
Child's Gender
*
Male
Female
Child's Date of Birth
*
MM
/
DD
/
YYYY
List any existing medical conditions, allergies, medications and/or special attention your child may require.
*
Your answer
Please check the Program your child will be attending.
*
Infant/Toddler
Before/Aftercare
Preschool
Required
Days Attending - Minimum 3 days scheduled per week to hold your place.
*
Monday
Tuesday
Wednesday
Thursday
Friday
Required
Parent/Guardian Name
*
Your answer
Address
*
Your answer
Phone Number
*
Your answer
Email
*
Your answer
How did you hear about us?
*
Your answer
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