Registration Form

All Fields required

In House Return Date: March 3rd
New Student Enrollment Period: March 8-19th
Open House: March 3rd (enrollment forms will be available & accepted)

Any application sent in prior to the appropriate postmark/submission date will be returned.

Child's Last Name
Child's First Name Middle Initial
Date Of Birth (mm/dd/yyyy)
Male Female
Asian Black Caucasian Hispanic Other
Father's Name
Address
City State Zip Code
Home Phone Cell
Email
Employer
Employer's Phone
Mother's Name
Click here if address/home phone is same as Father's
Address
City State Zip Code
Home Phone Cell
Email
Employer
Employer's Phone
Family Information:
Sibling's Name Age School
Sibling's Name Age School
Sibling's Name Age School
Child’s Previous Preschool or Daycare Experiences:

School/Day Care Provider 1 Days
Times Phone
School/Day Car Provider 2 Days
Times Phone
Yes, I authorize all staff employed through CECC access to all information in my child’s file including: health, personal, and academic information.

Please complete program selection for 3 & 4 yr olds: Please indicate which program you would like to enroll your child in by showing your 1st, 2nd, and 3rd choice.
3 Year Old - 2 Day a Week Program 3 Year Old AM - Monday and Tuesday, 8:30 AM – 11:00 AM Tuition = $1075.00 or 3 payments of $358.00 3 Year Old PM - Monday and Tuesday, 12:00 AM –2:30 AM Tuition = $1075.00 or 3 payments of $358.00
Mixed-Age - 3 Day a Week Program Mixed-Age AM- Wednesday, Thursday, Friday, 8:30 AM – 11:00 AM Tuition = $1575.00 or 3 payments of $525.00 Mixed-Age PM - Monday and Tuesday,12:00 PM – 2:30 PM Tuition = $1575.00 or 3 payments of $525.00
Mixed-Age - 5 Day a Week Program Mixed-Age AM, Monday – Friday, 8:30 AM – 11:00 AM Tuition = $2175.00 or 3 payments of $725.00 Mixed-Age PM, Monday – Friday, 12:00 PM – 2:30 PM Tuition = $2175.00 or 3 payments of $725.00
Readiness Applications May Be Sent in at Any Time.
Yes, we would like to apply for School Readiness Program
Lunch Bunch – Please check if you are interested** Extra hour @ $5/day. This program will only be offered if slots are filled