Pre-Enrollment Registration Form

Thank you for your interest in Somerset Pre-Kindergarten Academy. Choosing a quality child care program is one of the most important decisions you will make. We take your decision seriously and are committed to living up to the important responsibility of caring for your child. To begin the registration process, please return this completed form to Somerset Pre-Kindergarten Academy with a nonrefundable registration fee of $100.00 per child.

Once your registration form and fee are received we will start you on the road for completing additional enrollment and registration documents. We will walk you through the enrollment process step-by-step. During the enrollment process, we will also schedule time for you to meet your child’s classroom teacher and assistant, discuss our programs and goals, tour the facility, and review the Somerset PreKindergarten Academy policies and procedures.

Child’s First Name

Child’s Middle Name or Initial

Child’s Last Name

Child’s Date of Birth:

Parent Guardian Information:

Parent #1 First Name

Parent #1 Last Name

Relationship to Child:

Home Street Address

Home City, State, Zip Code

Home Phone:

Employer Phone:

Cell Phone:

Parent #1 Employer

End Section

Parent Guardian Information:

Parent #2 First Name

Parent #2 Last Name

Relationship to Child:

Home Street Address

Home City, State, Zip Code

Home Phone:

Employer Phone:

Cell Phone:

Parent #2 Employer

End Section

Enrollment Type: (Circle Type)

Full-Time

Part-Time

Days of the Week: (Check Days)

Parent/Guardian Signature:

Date Signed:

For Somerset Pre-Kindergarten Academy Office Use Only:

Date of Offer

Staff Initials

Classroom

Start Date

Accept/Decline

Accept

Decline

Date Registration Fee Paid

Tuition Type:

NOTES:

Parent Guardian Information:

Parent Guardian Information:

For additional information on Somerset Academy Early Learning Center

Somerset Academy Early Learning Center

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