Bostleys Registration Form Child Care Preschool printable pdf download

Bostleys Registration Form Child Care Preschool

Bostley’s

REGISTRATION FORM

Child Care

Preschool

Before and After Public School Care

School Age Summer Program

Private Kindergarten

Please check which location your child will attend:

____Bostley’s Preschool Learning Center Inc.

Fairfield Center 1504 Broad St. Montoursville, PA 17754

570.368-8007 or fairfieldacademy@comcast.net

____ Bostley’s Preschools LLC,

Dewey Ave, 1743 Dewey Ave. Williamsport, PA 17701

570.327-1144 or bostleys2@comcast.net

____Bostley’s Preschools LLC,

Hughesville 571 Rt. #405 Hwy, Hughesville, PA 17737

570-584-5303 or bostleys3@comcast.net

____Bostley’s LLC

Williamsport Center 918 Walnut St. Williamsport, PA 17701

570.326-1665 or bostleys4@comcast.net

Name of Child(ren):________________________ Birthdate __________

_________________________Birthdate __________

Today’s Date: _________________

Attendance will begin on:__________________

Full Time___ Part Time___Circle Part Time Days Needed M T W Th F

School District of Residence________________________________

Email Address _____________________Phone # _______________

Parent’s Name (Printed) ______________________________

Signature of Parent or Guardian:

_____________________________________

Please attach check for any applicable registration fee and / or tuition

payable to “Bostley’s” and mail to the correct above address.

______ I am participating in the CCIS Program and my caseworker is



_________________.

Bostleys Registration Form Child Care Preschool