enrollment and forms
ADVENT LUTHERAN PRESCHOOL
APPLICATION FOR ENROLLMENT
11800 W. 151ST Street, Olathe, KS 66062 (913) 681-5829
Date Received _______________ Registration Fee $50.00 _________ Paid: Check q Cash q
(non-refundable)
Name of Child ________________________________ Name we should use, if different _________________
Boy q Girl q Child’s Date of Birth _______________
Home Address ________________________________ City __________________ State, Zip _____________
Home Phone number ____________________________
Email address for parent ________________________________________
Mother’s name ______________________________ Father’s name _________________________________
Parent’s Address if different than above ________________________________________________________
Mother’s business phone ______________________ Mother’s cell phone _____________________________
Father’s business phone ______________________ Father’s cell phone ______________________________
Other children in family and ages _____________________________________________________________
Child lives with Both parents q Mother q Father q Guardian q
Contact parent in case of emergency _____________________________ Phone ________________________
Secondary person to contact ___________________________________ Phone _________________________
Names of those authorized to pick child up from school ____________________________________________
_________________________________________________________________________________________
Does your child have any known allergies we need to be aware of? Please specify _______________________
Is your child on any regular medication or prescriptions? If so, specify ________________________________
Please specify any pertinent information that would be helpful, disabilities, nose bleeds, toilet problems, fears, habits, speech issues ________________________________________________________________________
Has your child had any previous exposure to children’s groups, Sunday School or preschool? Yes q No q
If so, please specify ________________________________________________________________________
Advent Lutheran Church/preschool may use, for promotional purposes, any photographs taken of the child named above.
Parent’s signature __________________________________________ Date _____________
PLEASE SEE OTHER SIDE FOR AVAILABLE CLASSES
ADVENT PRESCHOOL CLASSES
All morning class hours are 9:00 a.m. to 11:30 a.m.
All afternoon class hours are 12:30 p.m. to 3:00 p.m.
Five year old program, $175.00 per month Extended care program, $15.00 per day
_____ M, T, W, F mornings _____ Monday afternoon (11:30 - 2:30)
_____ M, T, W, F afternoons _____Tuesday morning (9:30 - 12:30)
_____Tuesday afternoon(11:30 - 2:30) _____Wednesday morning(9:30 – 12:30)
_____Wednesday afternoon (11:30 - 2:30)
Note: There is a student minimum of 5 per class
and a maximum of 12 per class for extended care.
Four year old program, $145.00 per month Extended care program, $15.00 per day
_____ M, W, F mornings _____Monday afternoon(11:30 – 2:30)
_____M, W, F afternoons _____Wednesday morning(9:30 – 12:30)
_____Wednesday afternoon (11:30 - 2:30)
Note: There is a student minimum of 5 per class
and a maximum of 12 per class for extended care.
Three year old program, $115.00 per month Extended care program, $15.00 per day
_____ T, Th mornings _____Tuesday morning(9:30 – 12:30)
_____ T, Th afternoons _____Tuesday afternoon(11:30 – 2:30)
Note: There is a student minimum of 5 per class
and a maximum of 12 per class for extended care.
Two 1/2 year old Kid’s Day Out prgram, $110.00 per month
_____ Tues/Thurs. (9:00 - 11:30)
_____ Mon/Wed. (9:00 - 11:30)
For more information please call
Jean Carlson, Director of Advent Preschool
Preschool office (913) 681-5829
Church office (913) 681-2074
Jean’s home (913) 780-6457