New Student Registration Form

Mother's Full Name (required)

Father's Full Name (required)

Child's Full Name (required)

Child's Gender (F or M) (required)

Child's Birthday (mm/dd/yyyy) (required)

If you are registering for the K-5 program, what grade will he/she be in (for this coming school year)? If not applicable, simply write "N/A".

Are you registering for FREE preschool classes or Co-Op preschool? If Yes, which sessions and which days? For our preschool (3-5yo), please type something like this: "Fall Quarter, Session 2-4, Mondays." For our Co-Op preschool (1-3yo), please type "Wednesdays 9am-12pm." (required)

What classes/sessions and days are you interested in enrolling your child? For preschool, "Winter Quarter, Session 2 and 3, Mon & Wed & Fri." For Co-Op, please type "Tues & Thurs 9am-12pm." (required)

When do you want to start or join our program? (required)

Do you have any promotional code? If Yes, please specify here.

How did you hear about our programs?

Who else may pick up your child? Please write the full name of the person here.

Your Home Address (including city and zip code please) (required)

Your Phone Number (required)

Your Email (required)

Please type your email address again:

Can you tell us something about your child? What would you like him/her to learn or improve in class? What are his/her strengths or weaknesses? Please be very specific.

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