Admission Application

Address*

Parent's Information
Parent Full Name*
First NameLast Name
Parent E-mail*
Optional: Parent 2
Parent 2 Full Name
First NameLast Name
Parent 2 E-mail
Please Select Desired Program*
Toddler 5 Days - Mon-FriNursery 5 Days - Mon-FriPre-K 5 Days - Mon-Fri
Preschool Length of Day
8-9 AM Early Care1-3 PM Extended Day Program1-4 PM Extended Day Late Program1-5 PM Extended Day Late Program
How did you hear about Chai Preschool?
Comments
New applicants, please include a one time, non-refundable administrative fee of $75.00 to be added to waitlist.
Payment*
To pay with Card
$75

Payment

Credit Card

Billing Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

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Child's Information