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Bethel Christian Preschool Interest and Enrollment Form
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* Indicates required question
Child's Full Name
*
Your answer
Date of Birth:
*
MM
/
DD
/
YYYY
Gender:
*
Female
Male
Parent's Name
*
Your answer
Address:
*
Your answer
Telephone Number:
*
Your answer
Email address:
*
Your answer
Program Desired:
*
3 year old program (9:00-11:30 T/Th) 3 years old by Sept 1, 2021
4 year old program (9:00-11:30 M/W/F) 4 years old by Sept 1, 2021
I am ready to enroll and pay the $55 registration fee
*
Yes, I am ready to do that now
No, I am just letting you know of my interest; I am still deciding
How did you find out about our program?
*
internet
driving by
friend/family member
Other:
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