Southwest Preschool 2008-2009

Registration Form

Child’s Name _____________________________________  Boy_____Girl_____

Name child goes by ________________________________________________

Phone _______________ Parent’s Names ______________________________

Address __________________________________________________________

City/Zip __________________________________________________________

Child’s date of birth (must be 3 by Sept. 1st) ___________________________
          (must be potty trained to enter)

Do you prefer morning or afternoon classes? ____________________________

Reason? __________________________________________________________

How did you hear about Southwest Preschool? __________________________
             If a friend, who? ___________________________________________

Do you regularly attend a church? ________ If yes, where? _______________

Are you attending another preschool or on a waiting list elsewhere? ________
             If yes, where? _____________________________________________

Your nonrefundable $50 registration fee is due with your registration form.
This does not guarantee a spot in class.  If we are full, you will be placed on a
waiting list and your check will be cashed.  You will receive notification of your
placement in the spring.

For more information, please call Terri Burnette @624-9356 or Gail Hess @639-4400.

Mail form and fee to:
Southwest Preschool, 9725 SW Durham Road, Tigard, OR 97224