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The Ivy League Preschool I & II 2342 Route 32 and 262 Windsor Highway MAILING ADDRESS New Windsor, New York, 12553 Phone 1-845-534-0164 Phone 1-845-568-6044 2008-2009 REGISTRATION (Please complete and return with the non-refundable $95.00 application fee.) NAME:______________________________________________________ ADDRESS:___________________________________________________ __________________________________________________________ TELEPHONE:(HOME)________________________ DATE OF BIRTH:_____________________________________ CHILD’S CURRENT SCHOOL________________________________________________ SIBLINGS: AGE: __________________________________________________________ ______________________________________ FATHER'S NAME ____________________________________ MOTHER’S NAME _____________________________________ HOME ADDRESS (IF DIFFERENT FROM CHILD) ________________________________________ WORK TELEPHONE NUMBERS ______________________________________ FATHER'S EMPLOYER __________________________________________ MOTHER'S EMPLOYER PROGRAM ENROLLED: NURSERY 3-4 PRESCHOOL 4-5 KINDERGARTEN 5-6 INFANTS - Full Week Only DAYS ENROLLED: MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY TIMES ENROLLED: 9:00 TO 11:30 9:00 TO 12:00 9:00 TO 3:00 12:30 TO 3:00 8:30 TO 5:00 EXTENDED HOURS PERSON OR PERSONS TO CONTACT IN CASE OF EMERGENCY. ___________________________________________________________ NAME PHONE ___________________________________________________________ NAME PHONE |