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KinderHaus Pre-Enrollment Application
Hi! This form is no longer in use. Please fill out the curent pre-enrollment application form at
https://forms.gle/b2HKSa3Fbv8y1zkAA
. Thank you!
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* Indicates required question
Your Name
*
Your answer
Your eMail
*
Your answer
Your Phone Number
*
Your answer
Child's first name
*
Your answer
Child's middle name
*
Your answer
Child's last name
*
Your answer
Child's nickname
*
Your answer
Child's birthday or approximate due date
*
MM
/
DD
/
YYYY
Child's gender
*
Your answer
Child's primary language
*
Your answer
Parent/guardian's primary language
*
Your answer
Child's home address
*
Your answer
City
*
Your answer
State
*
Your answer
Zip code
*
Your answer
Days attending
*
Monday
Tuesday
Wednesday
Thursday
Friday
Required
May we ask how you heard about KinderHaus?
Local Referral (family or friend)
Social Media (Facebook, etc)
Web Search (Google, etc)
Not exactly sure! (heard of you!)
Any that apply
Local Referral (family or friend)
Social Media (Facebook, etc)
Web Search (Google, etc)
Not exactly sure! (heard of you!)
Any that apply
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Notes you would like to add
Your answer
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