Life Family Preschool Application

Life Family Preschool (formerly New Brighton Christian Assembly Preschool) admits students of any race, color, national and ethnic origin to all the rights, priviledges, programs and activities generally accorded or made available to students at school. It does not discriminate on the basis of race, color, national or ethnic origin in administration of its educational policies, admission policies and all school-administered programs.

If you need more information regarding our Preschool, please contact Miss Maggie (our Preschool Director) by calling 724.846.8820 extension 22 or email her at maggiez17@hotmail.com

Tell us about your child

Name

Nickname

Birthdate

Gender

Home Phone

Address

What school will your child be attending after graduation from Preschool? (School District or Home School)

Tell us about your family

Father's Name

Father's Cell Phone

Father's Employer

Employer Phone

Mother's Name

Mother's Cell Phone

Mother's Employer

Employer Phone

Parent's Marital Status

Parent's Email

This address will receive a confirmation email

In case of emergency

Emergency Contact (This person will be contacted if parents cannot be reached)

Relationship to child

Phone

Address

Tell us about your child's health information

Are your child's immunizations up to date?

Please list ANY allergies

Please list any medical conditions noted

Please list any special academic conditions noted

Please share with us any information that will help us to better understand your child. For example, habits, temperaments, any recent additions or changes to your family.

How did you hear about Life Family Church Preschool?

By typing my full name in this box, I am saying that all information included in this application is true and accurate and that I intend to enroll my child in the Life Family Church Preschool.

Preschool Class and Information

4 & 5 year old class
Monday-Tuesday- Wednesday
9am- 12pm
$110 per month

3 year old class
Thursday-Friday
9am- 12pm
$85 per month

I am enrolling my child in the

4 & 5 year old class 3 year old class

A $15 non-refundable registration fee is due upon submitting this application form.
Checks can be mailed to:
Life Family Preschool
1810 Valley Avenue
New Brighton, PA 15066

Cash or check accepted.

*Please make checks payable to Life Family Preschool

Life Family Preschool Application

Description

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