Pristine Children's Learning Academy Preschool Enrollment Inquiry Form

Thank you for your interest in Pristine Children's Learning Academy! Please fill out the form below and we'll be in touch shortly.

Parent/Guardian Information:

First name

Last name

Phone

Preferred Contact Method

Phone

Text

Child's Information:

Child's Full Name:

Date of Birth:

Current Childcare Situation:

Enrollment Interest:

Desire Start Date:

Days/Hour Needed (e.g., M/W/F, Mornings, Full-time):

Program Level:

Toddlers

Preschool

Pre-K

Tour Request:

Would you like to schedule a tour?

Preferred Date/Times:

Month

Day

Year

Time

HoursMinutes

Additional Info:

How did you hear about us?

Any medical or development notes we should know? (If not, please type N/A)

What are you looking for in a preschool?

Consent:

I agree to be contacted by Pristine Children's Learning Academy about enrollment and related updates.