Thank you for your interest in enrolling your child in one of our programs at Little Brick Schoolhouse! Please fill out this form as complete and correctly as possible.

*   denotes required fields

Referral Information
Family Information
Where do you live?
Additional Info
Contact #1
How Can We Contact You?
Portal Access (your email is your login)
(Emails are kept confidential)
Who is your employer?
Contact #2
How can we contact you?
(Emails are kept confidential)
Who is your employer?
Student #1
Additional Info

Please remember: Children who turn 4 on or before 8/31/2014 will be enrolled in 4 Year Old Preschool. Please only select the one program you would like your child enrolled in. Do not select more than one choice.

Request Classes
Select Class
Required Policies and Agreements
I Agree to All of the Above
Questions or Concerns
Payment Information
Credit Card
eCheck/Bank Draft
(Your name on your bank statement)
(9-digit number)