Preschool & Kinderprep Application Student Name Gender Address Email Home Church Baptism Date Ethnic origin of child American IndianAsianBlackHispanicWhiteOther Mother's Name Mother's Address Mother's Place of Employment Mother's Cell Number Mom's Email Father's Name Father's Address Father's Place of Employment Father's Cell Number Father's Email Marital Status singlemarriedseparateddivorcedwidowed Legal Custody is with: Child's resides with Other children in the home Does your child have an allergies? YesNo Describe the allergic reaction Previous Group Experience playgroup preschool child care Sunday School None Do you consider your child to be: right-handedleft-handednot sure What do you expect your child to gain from Mount Olive Lutheran Preschool? Give any futher information which you believe will be helpful to us in understanding your child. How did you become aware of Mount Olive Lutheran School? Submit
