Common use of Please check one Clause in Contracts

Please check one. Re-Enrollment New Registration How did you hear about our program? Alumni Family Friend/Family Website Facebook Other Student’s Information Last Name First Name Middle Name Name you would like your child to be called: Birth Date / / Sex Primary Home Language Parent/guardian primary home language Child’s Home address City State Zip Family Information List family members and pets your child lives with – include first names, relation and ages of siblings Are both parents at home? If no, which parent is present? General Comments: Parent Information Mother/Guardian’s Name Father/Guardian’s Name Home Address (include street, city, state, zip) Home Phone Number Cell Phone Number Employer Occupation Business Phone Number Email address (checked often) Best number to reach you at

Please check one. Re-Enrollment New Registration How did you hear about our program? Alumni Family Friend/Family Website Facebook Other Student’s Information Last Name First Name Middle Name Name you would like your child to be called: Birth Date / / Sex Primary Home Language Parent/guardian primary home language Child’s Home address City State Zip Family Information List family members and pets your child lives with – include first names, relation and ages of siblings Are both parents at home? If no, which parent is present? General Comments: Parent Information Mother/Guardian’s Name Guardian Father/Guardian’s Name Guardian Home Address (include street, city, state, zip) Home Phone Number Cell Phone Number Employer Occupation Business Phone Number Email address (checked often) Best number to reach you at