Madison Little Blessings Preschool Enrollment 2024

Thank you for enrolling at Little Blessings Preschool. Please fill this form out as completely as possible and submit it with your registration and materials fee. If you have any questions, please email handerson@gslcwi.com

Child Information

Name

Address

Birthdate

Phone

This number will be used in case of an emergency.

Please list any medical concerns/allergies

Please list any rescue medication

Parent Information

First parent full name

First parent home phone (if different from above)

First parent cell

This address will receive a confirmation email

Place of employment

Work number

Second parent full name

Second parent cell

Second parent email

Place of employment

Work number

How did you hear about us?

Madison Programs

Year round: Indicate desired start date

School Year: Starts September 3, 2024 or later. Indicate Desired Start Date:

Preschool Options (please go to next section if registering for 4K or afterschool programming)

Please select all that apply.

Monday Full Day 7:30 a.m.-6:00 p.m. Tuesday Full Day 7:30 a.m.-6:00 p.m. Wednesday Full Day 7:30 a.m.-6:00 p.m. Thursday Full Day 7:30 a.m.-6:00 p.m. Friday Full Day 7:30 a.m.-6:00 p.m. Monday Morning 8:30 a.m.-11:30 a.m. Tuesday Morning 8:30 a.m.-11:30 a.m. Wednesday Morning 8:30 a.m.-11:30 a.m. Thursday Morning 8:30 a.m.-11:30 a.m. Friday Morning 8:30 a.m.-11:30 a.m.

4K Options

Please select one option.

Monday Full Day 7:30 a.m.-6:00 p.m. Tuesday Afterschool 3:00 p.m.-6:00 p.m. Wednesday Afterschool 3:00 p.m.-6:00 p.m. Thursday Afterschool 3:00 p.m.-6:00 p.m. Friday Afterschool 3:00 p.m.-6:00 p.m.

Afterschool Options

Please select one option.

Monday 3:00 p.m.-6:00 p.m. Tuesday 3:00 p.m.-6:00 p.m. Wednesday 3:00 p.m.-6:00 p.m. Thursday 3:00 p.m.-6:00 p.m. Friday 3:00 p.m.-6:00 p.m.

Signature (type name)

Today's date

Registration & Material Fee

This fee is non-refundable and is not applied to tuition. To enroll your child return this form and the fee to the school.

Payment $125.00

Credit/Debit Card Number

Expiration Date/CVC

Name on Card

Card Billing Address

Madison Little Blessings Preschool Enrollment 2024

Description

Please Fix the Following