School of Early Learning Online Registration

Registration

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SCHOOL OF EARLY LEARNING PRESCHOOL REGISTRATION FORM 2024-2025

* denotes required fields

Referral Information

How did you hear about us?

Referral Name

Family Information

Family Last Name*

Where do you live?

Home Address*

City*

State*

Zip*

Primary Phone*

Additional Info

Emergency Contact Info*

Dismissal Contact Name/Phone*

Dismissal Contact Name/Phone

Contact #1

Contact #1 First Name*

Last Name *

Type*

How Can We Contact You?

Home Phone

Work #

Cell # *

Portal Access (your email is your login)

Email* (Emails are kept confidential)

Confirm Email*

Portal Account Password

Confirm Portal Account Password

Contact #2

Contact #2 First Name

Last Name

Type*

How can we contact you?

Home Phone

Work #

Cell #

Email (Emails are kept confidential)

Confirm Email

Student #1

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

Special Needs

Allergies

Medications*

Is the child potty Trained*

Attending kdg after this year?*

Has child attended preschool?*

Please complete the online registration form and submit the non-refundable $50 registration fee per child. Once the registration fee and form are received, your child will be placed into a class if there is an opening. Parent packets of information will be sent in June. Any questions, please email kaitlyn@auburnumc.church

Your credit card is not automatically charged when you add payment information below, it is just a requirement to complete the registration process. Your card is only charged when you select a fee to pay once logged into your parent portal. If the registration fee does not get automatically applied to your account it will be applied manually and you will be notified!

Enroll in Classes

Select Class *

Student #2 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

Special Needs

Allergies

Medications*

Is the child potty Trained*

Attending kdg after this year?*

Has child attended preschool?*

Enroll in Classes

Select Class *

Student #3 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

Special Needs

Allergies

Medications*

Is the child potty Trained*

Attending kdg after this year?*

Has child attended preschool?*

Enroll in Classes

Select Class *

Student #4 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

Special Needs

Allergies

Medications*

Is the child potty Trained*

Attending kdg after this year?*

Has child attended preschool?*

Enroll in Classes

Select Class *

Student #5 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

Special Needs

Allergies

Medications*

Is the child potty Trained*

Attending kdg after this year?*

Has child attended preschool?*

Enroll in Classes

Select Class *

Add Another Student

Required Policies and Agreements

(Show-Hide Details)

Payment Policies

I've read the above and agree.

Non-Discrimination Policy

I've read the above and agree.

I Agree to All of the Above

Enter your Full Name* December 10, 2024

Questions or Concerns

Comments

Payment Information

Please fill out CREDIT CARD Payment Method

Credit Card

Card Number *

Exp Month *

Exp Year *

Card Nickname

Name as it appears on card *

Address Line 1

Address Line 2

City

State

Zip*

eCheck/Bank Draft

Bank Name

Account Type

Your Account Name (Your name on your bank statement)

Bank Routing Number (9-digit number)

Account Number

Registration

Referral Information

Family Information

Where do you live?

Additional Info

Contact #1

How Can We Contact You?

Portal Access (your email is your login)

Contact #2

How can we contact you?

Student #1

Additional Info

Enroll in Classes

Student #2 (Show-Hide Details)

Additional Info

Enroll in Classes

Student #3 (Show-Hide Details)

Additional Info

Enroll in Classes

Student #4 (Show-Hide Details)

Additional Info

Enroll in Classes

Student #5 (Show-Hide Details)

Additional Info

Enroll in Classes

Required Policies and Agreements (Show-Hide Details)

I Agree to All of the Above

Questions or Concerns

Payment Information

Credit Card

eCheck/Bank Draft

Required Policies and Agreements

(Show-Hide Details)