Request for Enrollment Packet- The Edison ELC
Thank you for your interest in The Edison Early Learning Center. Please complete the following form in order to receive an enrollment packet. We are looking forward to having your family join our academic programs at Edison.
Email *
Parent Name(s): *
Email *
Child 1 Name
Child 1 DOB
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Classroom Interested In Enrolling - All incoming Pre-K 4 & Jr. Kind. students will participate in a developmental screening prior beginning of school year.
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Child 2 Name
Child 2 DOB
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Classroom Interested In Enrolling - All incoming Pre-K 4 & Jr. Kind. students will participate in a developmental screening prior beginning of school year.
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Address *
Phone number
When would you like to enroll your child? (please note classrooms may have a wait list)
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Would you like to be placed on our wait list, if needed?
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Does your child currently receive early intervention services or have an IEP?  If so, please explain services or delays.
Do you have any developmental concerns regarding your child's development? If so, please explain.
Is your child potty trained?
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Do you have any questions at this time?
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