Online Registration Form
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Note: Our registrar can be reached at registrar@poulsbocooppreschool.org if you have any questions. You can now register online for all our classes. After registration, our registrar will send you a confirmation e-mail which will include more detailed class information and a request to remit the one-time, non-refundable registration fee of $40 to guarantee enrollment. Thank you!
Class Requested
*
Wiggleworms (2-3 years)
Tuesday, 9:30 - 11:30 am
Friday, 9:30 - 11:30 am
Bumblebees (3-4 years)
Mon. & Wed. 9:30 - 12:00 pm
Dragonflies (4-5 years)
Mon., Wed. & Th., 12:30 - 3:00 pm
Child's Name
*
Birthdate
*
January
February
March
April
May
June
July
August
September
October
November
December
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
Parents/Guardians' Names
*
Address
*
City, St Zip
*
,
Telephone
*
Cell phone
Email
*
Special Concerns for your Child
*
=required
Updated: Thursday, April 16, 2009 9:13 AM
