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Carmel Cooperative Preschool
2023-2024 Enrollment
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Email
*
Your email
Child's First Name
*
Your answer
Child's Last Name
*
Your answer
Child's Nickname
Your answer
Birthday
*
MM
/
DD
/
YYYY
Gender
M
F
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Family Contact 1 - Full Name
*
Your answer
Family Contact 1 - Relationship to Child
*
Mother
Father
Grandparent
Legal Guardian
Other:
Family Contact 1 - Street Address
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Your answer
Family Contact 1 - City
*
Your answer
Family Contact 1 - Zip Code
*
Your answer
Family Contact 1 - Phone Number
*
Your answer
Family Contact 1 - Email
*
Your answer
Family Contact 1 - Occupation/Field
Your answer
Family Contact 2 - Full Name
Your answer
Family Contact 2 - Relationship to Child
Mother
Father
Grandparent
Legal Guardian
Other:
Clear selection
Family Contact 2 - Street Address
leave blank if same as above
Your answer
Family Contact 2 - City
leave blank if same as above
Your answer
Family Contact 2 - Zip Code
leave blank if same as above
Your answer
Family Contact 2 - Phone Number
Your answer
Family Contact 2 - Email
Your answer
Family Contact 2 - Occupation/Field
Your answer
Who will be the primary person who participates in the classroom?
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Your answer
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