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The Ivy League
Preschool I 2342 Route 32 New Windsor, New York, 12553
Phone
1-845-534-0164
Phone 1-845-721-2908 2014-2015
REGISTRATION
(Please complete and return with the non-refundable $95.00 application fee.)
NAME:______________________________________________________
ADDRESS:___________________________________________________
__________________________________________________________
TELEPHONE:(HOME)________________________
DATE OF BIRTH:_____________________________________
CHILD’S CURRENT SCHOOL________________________________________________
SIBLINGS: AGE:
__________________________________________________________
______________________________________
FATHER'S NAME
____________________________________
MOTHER’S
NAME
_____________________________________
HOME ADDRESS (IF DIFFERENT FROM CHILD)
________________________________________
WORK TELEPHONE NUMBERS
______________________________________
FATHER'S EMPLOYER
__________________________________________
MOTHER'S EMPLOYER
PROGRAM ENROLLED: NURSERY 3-4 PRESCHOOL 4-5 KINDERGARTEN 5-6 INFANTS - Full Week Only
DAYS ENROLLED: MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY
TIMES ENROLLED: 9:00 TO 12:00 9:00
TO 3:00 6:30 TO 6:00 8:30 TO 5:00 EXTENDED HOURS
PERSON OR PERSONS TO CONTACT IN CASE OF EMERGENCY.
___________________________________________________________
NAME PHONE
___________________________________________________________
NAME PHONE
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