Creative Spark

Magic Sparks Preschool Program

Application for Enrollment

Today’s Date _______________

Applying For (circle one) 2006-2007 2007-2008 2008-2009 Other _____________

(Child MUST be 3 years old by September 1^st. Sorry, no exceptions.)

Your Child’s Full Name: __________________________ M / F Birthdate: ___________________

Parent’s Names: ___________________________________ Home Phone: ____________________

Street Address: _____________________________________ Cell Phone(s): _____________________

City, State, Zip: ____________________________________ Work Phone(s): ___________________

Email (or other numbers): ______________________________________________________________

Enrollment Preferences

Please indicate your 1^st, 2^nd, and 3^rd choices for enrollment.

MAGIC SPARKS (9:00am – 12:00 pm)

___ M-W-F (3 days per week) ___ T-Th (2 days per week)

MAGIC SPARKS (9:30 am – 12:30 pm)

___ M-T-W-Th-F (5 days per week)

LEARNING EXTENSIONS (12pm – 2pm)

(Child must be 4 ½ by September 1^st)

___ M-W-F (3 days per week) ___ T-Th (2 days per week) ___ M - F (5 days per week)

In Addition, please register my child for the following:

Circle every day for which you would like to participate

EARLY BIRDS (8:30am) Drop-offs will be accepted on a space available basis

___ Mon Tues Wed Thurs Fri

___ Mon Tues Wed Thurs Fri

Why have you chosen this program for your child?

Are there any characteristics that you are particularly proud of in your child?

Please describe what you expect your child and your family to gain from this program?

Additional Comments:

Mt. Pleasant, SC, 29464

Learningextensions@comcast.net