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3 years ago

preschool enrollment application

preschool enrollment application

preschool enrollment

John E. McCormac, MayorWOODBRIDGE COMMUNITY CENTER600 Main Street, Woodbridge, NJ 07095Phone: 732-596-4170 Fax: 732-596-4187PRESCHOOL ENROLLMENT APPLICATIONCHILD’S NAME______ D.O.B.____________ SEXADDRESS ________________________________________________FATHER’S NAME MOTHER’S NAME _______________ __ ______ADDRESS ______________________ ADDRESS _________________ _____ ______HOME PHONE___________________ HOME PHONE ____________________________E-MAIL _________________________E-MAIL _____________________ ________WHERE TO REACH PARENT:FATHER’S OCCUPATION __________________ __________________PLACE OF BUSINESS ____________________ __________________BUSINESS PHONE ______________________ __________________MOTHER’S OCCUPATION _________________ __________________PLACE OF BUSINESS ____________________ __________________BUSINESS PHONE ______________________ __________________EMERGENCY CONTACT IF NEITHER PARENT IS AVAILABLE:(Emergency contact must be less than 30 minutes away from preschool)NAME ____________________RELATIONSHIP _____________ADDRESS _________________PHONE ___________________DOCTOR INFORMATION:NAME ________________RELATIONSHIP _________ADDRESS _____________PHONE _______________CHILD’S DOCTOR __________________________________________ADDRESS ________________________________________________PHONE __________________________________________________PARENT SIGNATURE:DATE _________1

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