Preschool Enrollment Form

Pre-School Enrollment Form

Enrollment Form for Preschool

Child's Name(Required)

First Last

Date of Birth(Required)

Sex:(Required)

Home Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Parent's Name(Required)

First Last

Parent's Name

First Last

Home Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Home Address (If Different)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone(Required)

Phone

Email(Required)

Workplace Name(Required)

Workplace Name

Workplace Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Workplace Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Workplace Phone

Workplace Email

Child's Legal Guardian if different from above:

Child Care Needs:(Required)

Monday

Tuesday

Wednesday

Thursday

Friday

Times(Required)

Half Day (8-12)

Full Day

Beginning(Required)

Summer

Fall

Year?(Required)

(Child must be 3 years of age on or before July 1st for Summer Session and on or before September 1st for Fall Session)

Fee

A $25.00 non-refundable registration fee is required before enrollment is secured. Please mail the registration fee to: Gorham House Preschool 50 New Portland Road Gorham, ME 04038. If enrollment is not immediately available, your completed registration form and fee will automatically place your child on the waiting list for the next available spot.

Pre-School Enrollment Form

Fee

Directions