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Toddler Hour Pre-Registration


Child's First Name
Child's Last/Family Name
*Gender
Male
Female
*Date of Birth (MM/DD/YY)
*Relationship to Applicant
*Title
*Parent or Guardian First/Given Name
*Parent of Guardian Last/Family Name
Mailing Address
*Zip Code
*Home Phone
*Primary E-mail Address
Which Toddler Hour(s) would you like to attend?
Select as many as you would like to attend.
Does your child attend any other preschool progam(s)?
Yes
No
If so, where?
Do you recall which website, newspaper, magazine, billboard, radio station or sign from which you learned about Chapin School?
If yes, please name the source and/or describe briefly. If it's a Chapin parent, please tell us who he/she is. 
$20 Fee To Be Collected at Door (Cash or Check Only)
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