2019-2020 Los Altos Grace Pre-School Registration
Most classes are currently full. Please contact us for availability.
If you complete and submit this online registration and your child's class is full, we will contact you as soon as there is an opening. Thank you!
Name
*
Email
*
This address will receive a confirmation email
Phone
*
Address
*
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Student's Name
*
Student's Birth Date
*
Student's Gender
*
Please select one option.
Male
Female
Select Option
Male
Female
Preferred Days and Times
Please Select Your Preferred Days and Times Below...
Choose One.
Morning Preschool (8:45 am-12:15 pm)
Please select one option.
2 Days T/Th
3 Days M/W/F
5 Days M-F
Select Option
2 Days T/Th
3 Days M/W/F
5 Days M-F
Preschool With Partial Afternoon Care (8:45 am-3:00 pm)
Please select one option.
2 Days T/Th
3 Days M/W/F
5 Days M-F
Select Option
2 Days T/Th
3 Days M/W/F
5 Days M-F
Full Day Preschool (7:00 am-6:00 pm)
Please select one option.
2 Days T/Th
3 Days M/W/F
5 Days M-F
Select Option
2 Days T/Th
3 Days M/W/F
5 Days M-F
Family Information
If a field does not apply, please mark N/A.
Father's Name
*
Home Address (if different)
*
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AE
AK
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AP
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AS
AZ
BC
CA
CO
CT
DC
DE
FL
FM
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MB
MD
ME
MH
MI
MN
MO
MP
MS
MT
NB
NC
ND
NE
NH
NJ
NL
NM
NS
NT
NU
NV
NY
OH
OK
ON
OR
PA
PE
PR
PW
QC
RI
SC
SD
SK
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
YT
Occupation
*
Place of Employment
*
Business Address
*
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CA
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DE
FL
FM
GA
GU
HI
IA
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IL
IN
KS
KY
LA
MA
MB
MD
ME
MH
MI
MN
MO
MP
MS
MT
NB
NC
ND
NE
NH
NJ
NL
NM
NS
NT
NU
NV
NY
OH
OK
ON
OR
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PR
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Business Phone
*
Home Phone
*
Cell Phone
*
Father's Church Affiliation
*
Hobbies and Interests
Mother's Name
*
Home Address (if different)
*
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AA
AB
AE
AK
AL
AP
AR
AS
AZ
BC
CA
CO
CT
DC
DE
FL
FM
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MB
MD
ME
MH
MI
MN
MO
MP
MS
MT
NB
NC
ND
NE
NH
NJ
NL
NM
NS
NT
NU
NV
NY
OH
OK
ON
OR
PA
PE
PR
PW
QC
RI
SC
SD
SK
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
YT
Occupation
*
Place of Employment
*
Business Address
*
--
AA
AB
AE
AK
AL
AP
AR
AS
AZ
BC
CA
CO
CT
DC
DE
FL
FM
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MB
MD
ME
MH
MI
MN
MO
MP
MS
MT
NB
NC
ND
NE
NH
NJ
NL
NM
NS
NT
NU
NV
NY
OH
OK
ON
OR
PA
PE
PR
PW
QC
RI
SC
SD
SK
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
YT
Business Phone
*
Home Phone
*
Cell Phone
*
Mother's Church Affiliation
*
Hobbies & Interests
Child Information
Other People Living in Household
*
Language Spoken In Home
*
Does Your Child Have Any Speech Troubles?
*
Please select all that apply.
Yes
No
Does Your Child Need Help Dressing?
*
Please select all that apply.
Yes
No
Undressing?
*
Please select all that apply.
Yes
No
Washing Hands?
*
Please select all that apply.
Yes
No
Toilet?
*
Please select all that apply.
Yes
No
Eating?
*
Please select all that apply.
Yes
No
Has Your Child Had Group Play Experience?
*
Please select all that apply.
Yes
No
Please Tell Us About Any Particular Difficulty the Teacher Should Watch For
*
Church Information
If a field does not apply, please mark N/A.
What is Your Current Church?
*
What Would You Like Your Child to be Taught About God?
*
School Policy Information
How Did You Hear About Los Altos Grace Preschool?
*
Please Tell Us Your Primary Reason for Sending Your Child to Los Altos?
*
Student Registration
$150
Credit/Debit Card Number
Expiration Date/CVC
Name on Card
Card Billing Address
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AB
AE
AK
AL
AP
AR
AS
AZ
BC
CA
CO
CT
DC
DE
FL
FM
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MB
MD
ME
MH
MI
MN
MO
MP
MS
MT
NB
NC
ND
NE
NH
NJ
NL
NM
NS
NT
NU
NV
NY
OH
OK
ON
OR
PA
PE
PR
PW
QC
RI
SC
SD
SK
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
YT
Submit
Description
Most classes are currently full. Please contact us for availability.
If you complete and submit this online registration and your child's class is full, we will contact you as soon as there is an opening. Thank you!
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