Pre-School Enrichment Program Registration Form  

Today’s Date:

Child’s Name:                                                            Birthdate:

Elementary School Attendance Area:

Parent/Guardian’s Full Name

Address:

Father's Place of Employment:

Mother's Place of Employment

Telephone Numbers:       Home:

 Father/Guardian’s Work:

 Mother/Guardian’s Work:

Registration Deposit  $________________

    $30 Non-refundable Deposit to secure enrollment:

Make Checks Payable to:  Traverse City Area Public Schools

Day

A.M.  ONLY            8:00 - 11:00

P.M.  ONLY                    12:00 – 3:00

Full Day  8:00 - 3:00

Mon

Tue

Wed

Thurs

Fri

There is an additional $5/hr. fee for extended hours.

Please Return to: Central Grade School  301 W. Seventh St.,                  Traverse City, MI 49684