Preschool Application

August 2023 – May 2024

Child's Information

Child's Name(Required)

First Last

Date of Birth(Required)

Age(Required)

Gender(Required)

Previous Child Care

Family Church

Primary Payer(Required)

Days Attending

Full or Half Day(Required)

Days of the Week(Required)

Monday

Tuesday

Wednesday

Thursday

Friday

Father/Stepfather/Guardian

Name

First Last

Address

Street Address City State / Province / Region ZIP / Postal Code

Home Phone

Cell Phone

Cell Phone Carrier

Employer

Title

Work Phone

Mother/Stepmother/Guardian

Name

First Last

Address

Street Address City State / Province / Region ZIP / Postal Code

Home Phone

Cell Phone

Cell Phone Carrier

Employer

Title

Work Phone

Any other children?(Required)

Please list other children's names and ages

Does your child use the restroom independently?(Required)

A one-time non-refundable registration fee of $75 per student must accompany this application.
KCS accepts children in all its programs, regardless of race, creed, color, national origin or religious beliefs, as space allows, according to enrollment requirements and policies.

Signature (Type your full name)(Required)

Relationship to Child(Required)

Date(Required)

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Name*
First Last
Email*
Questions/Comments*
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