Record Sheet Name of Parent / Guardian Your Email (required) Your Telephone Are you coming through a Goverment Program? Which One? NoCalWorksCHSDOEOptionsOther Child's Name, Age, Gender Potty Trained YesNo Child's Name, Age, Gender Potty Trained YesNo Expected Date of Enrollment Expected Attendance Schedule Full Time: 5 DaysPart Time : 4 DaysPart Time : 3 Days Time Schedule 9:00AM - 3:00PM6:30AM - 4:30PM6:30AM - 6:30PM How did you discover us? Additional Information
