Charlton Preschool 2020-2021 Registration

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2021-2021 school year (Sept-May)
5920 Jonestown Rd Harrisburg PA 17112
Contact us at (717)545-8564 or preschool@charltonchurch.org

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Адрас электроннай пошты *

Child's Full Name *

Child's Current Age *

Name Used at Home

Child's Sex *

Male

Female

Child's Birthdate *

ММ

ДД

ГГГГ

Home Address *

Home Phone Number *

First Parent's Name *

First Parent's Phone Number (please label cell/home) *

First Parent's Email Address *

Same as Above

Іншае:

First Parent's Occupation *

Second Parent's Name

Second Parent's Phone Number (please label cell/home)

Second Parent's Email Address

Second Parent's Occupation

Has the child had any previous preschool experience? *

Yes

If yes, where?

Other groups/activities your child attends?

Additional information we should know about your child

Other children in family, please include ages

Names and Relationships of other adults in home

Далей

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