sa diamond head preschool application.pdf - amazon...
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2015-2016
Diamond Head Keiki Center Admission Application
OFFICE USE ONLY: Record #: ___________________ Admission Date: _________________________ Discharge Date: ___________________ Teacher / Caregiver: __________________________________________________ Group assignment: _________________ Other program involvement / Contacts: _______________________________ _______________________________ _______________________________ _______________________________
Child Information First and Last Name Preferred name or nickname
Date of Birth Gender: (circle) Male Female
Address (including city and zip code) Parent/ Guardian Information Mother’s / Guardian’s Name Contact phone number(s)
Address (if different from child’s) Email
Father’s / Guardian’s Name Contact phone number(s)
Address (if different from child’s) Email
How did you hear about our Keiki Center? _____________________________________________________________________
I am interested in this Keiki Center because: (check all that apply)
Convenient location Hours of operation are what I need Facilities are attractive
School philosophy meets my goals for my child
Tuition is reasonable Other:
There is a $25 non-refundable application fee. Please make a check out to Salvation Army FTS and send with the completed Application form to: Diamond Head Keiki Center 845 22nd Avenue Honolulu, Hawaii 96816 You will receive a Space Availability letter upon receipt of this application. Admissions are made year-round. Parent/ Guardian Signature: _______________________________________________________ Date: ____________________
If you have any further questions, feel free to contact us at 739-4931. Aloha!
2015-2016
OFFICE USE ONLY: ADMISSION FORMS
DATE RECEIVED
RESPONSE FORMS DATE SENT
Admission application and application fee
Space availability letter
Handbook policies and procedures acknowledgement form
Orientation schedule letter
CWS information
Acceptance packet
Getting to know your child questionnaire
Authorization for audio or video, film or photograph
First month’s tuition + comprehensive fee
Student’s health record (Form 14) and Supplemental early childhood forms (DHS 908)
Emergency information and authorization for pick-up
Notes:
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