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Me Too Preschool
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Please print the following forms and return to Me Too Preschool.

 

Application for Me Too Preschool Child Care 

Child's Name ______________________________________________________ 

Address ________________________________________________

Telephone ________________ DOB ___________ Sex: Male/Female

Days child will attend: M T W Th F     Hours attended _______________

Child care will be paid in advance per/wk on Wednesday at the rate of 

$ _______ 

Emergency alternates: (MUST LIST RELIABLE PEOPLE/NUMBERS)

Name _____________________ Phone _______________________

Name _____________________ Phone _______________________

 

MOTHER'S Name ________________________________________

Address _______________________________________________

Telephone _____________________ Cell _____________________

Employer _______________________________________________

Employer’s Address _______________________________________

Telephone ____________________ Job Title __________________

Days/Hours ___________________

 

FATHER'S Name _________________________________________

Address _______________________________________________

Telephone _____________________ Cell _____________________

Employer _______________________________________________

Employer’s Address _______________________________________

Telephone ____________________ Job Title __________________

Days/Hours __________________

 

ADDITIONAL CHILDREN

Name/DOB _____________________________________________

Name/DOB _____________________________________________

 

Mother’s Signature _______________________________________

Father’s Signature ________________________________________

Date Enrolled ___________

 

For office:

DOE ________________

ASD ________________