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                 MY FIRST SCHOOL PRESCHOOL APPLICATION

                                   a ministry of the first baptist church of aurora

                                                79 E. mEnnonite rD,, Aurora, ohio 44202

                                               phone:  330-562-8070      fax: 330-562-8244
 

Date of Application ______________________________ Date of Desired Enrollment ________________

Child’s Name _______________________________________ D.O.B. _____________________________

Male / Female (Circle One)   How you heard about us: ________________________________________

Parent(s) / Guardian (s) Names ___________________________________________________________

Address _______________________________________________________________________________

Home Phone ______________________________ Work Phone___________________________________

Cell Phone ________________________________________  e-mail ______________________________

Sibling(s) Name(s) and Age(s)     _______________________________    _________________________
           
                                             _______________________________    _________________________

Please enroll my child in the following program(s):

____ Infants One Day 9:00 – 12:00                          ____ Infants T/TH 9:00 – 12:00

____ Infants M/W/F 9:00 – 12:00                            ____Toddlers T/TH 9:00 – 12:00

____ Toddlers M/W/F 9:00 – 12:00                          ____ Preschool T/TH 9:00 – 12:00

____ Preschool M/W/F 9:00 – 12:00                        ____ Preschool M/W/F 1:00 – 3:30

____ Preschool M – F 9:00 – 12:00                          ____ Preschool M – F 9:00 – 3:00

___ Lunch Bunch M/W 12:00 – 1:00                        ___ Lunch Bunch T/TH 12:00 – 1:00
                                 (Parent/guardian provides sack lunch)

Teacher Assigned _________________________

School Year _____________________