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Montana Preschool Santa Monica
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When Space becomes available,
We will contact you by the order applications are received.
Last Name
*
Child’s Name
*
Child’s Date of Birth
*
Child’s age (as of today’s date)
*
Allergies
*
Parent 1 Name
*
Parent 1 Cell Phone
*
Parent 2 Name
*
Parent 2 Cell Phone
*
Parent 2 email
*
Home Address
*
Home Phone
*
I am interested in the following
Full Day (8:30am-5pm)
Afternoon Pickup (8:30am-3pm)
Half Day (8:30am-1pm)
Afternoon (1pm-3pm)
Number of days/week
5 days/ week
4 days/ week
3 days / week
2 days/ week
Desired Enrollment Start Date
*
Notes
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Please add my child to the waiting list for next September (Free of charge)
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