Preschool Enrollment Form

* Indicates required field

Full Name of Child *

Birth Date *

Name child is called *

Male or Female *

Home Address, City, & Zip *

Name of Parent *

First

Last

Phone *

Home Address, City, & Zip *

Email *

Employer & Occupation *

Work Address & Phone *

Time of Work Hours *

Name of Parent *

First

Last

Phone *

Home Address, City, & Zip *

Email *

Employer & Occupation *

Work Address & Phone *

Time of Work Hours *

Child resides with *

Names/Birth Dates of Siblings *

Daytime Care Giver *

Daytime Care Giver's Phone *

Person (s) authorized to take child from Broadway Preschool: *

Allergies/medical needs *

How did you hear about Broadway Preschool? *

School child will attend after preschool? *

Church Affiliation? *

Parent Signature & Date (Entering your name here is the equivalent of a signature.) *

Broadway Preschool Class Options
Please list your class choices in order of preference in the box at the end of this form.
Classes are open to students ages 3, 4 and 5. Students may enroll if their birthday is after August 1st but they will be three during the school year and are fully toilet trained. Students must be at least 2 years old before August 1st to enroll in the Early Enrichment Class and in the process of toilet training. Classes will be filled in the order forms and fees are received. You will be notified in advance if your first choice of class is not available.

5 Day Morning Class
Mon./Tues./Wed./Thurs./Fri. - 8:15a.m.-11a.m.
$40 Enrollment Fee, $150 tuition x 9 months

3 Day Morning Class
Mon./Wed./Fri. - 8:15a.m.-11a.m.
$40 Enrollment Fee, $150 tuition x 9 months

3 Day Afternoon Class
Mon./Wed./Fri. - 12:15p.m.- 3p.m.
$40 Enrollment Fee, $135 tuition x 9 months

2 Day Early Enrichment Class
Tues./Thurs. - 8:30a.m.-10:30a.m.
$40 Enrollment Fee, $135 tuition x 9 months

$40 enrollment fee is non-refundable and should be turned in with the enrollment form.
Please go to the GIVE button, on the home page navigation bar, to make your enrollment or tuition payments. You can set up once a month tuition payments or recurring payments.
Tuition for the school year is divided into 9 monthly payments.
First tuition payment must be paid by August 1st to secure your child's place in a class.

Classes in order of choice. *

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