We are now accepting applications for the 2011-2012 school year.

FRIENDS TOGETHER

UNITED METHODIST PRESCHOOL

823 Merchant

Emporia, KS 66801

(620) 342-6186

ENROLLMENT FORM

Child’s Full Name__________________________________________________

Child’s Nickname or Name child should be called__________________________

Birth date_____________________    Boy____________    Girl_____________

Address_________________________________________________________

Parent’s Name____________________________________________________

Phone (Home) ______________________   (Work) ______________________

How did you hear about our program?__________________________________

NOTE: A $30.00 non-refundable enrollment fee should accompany this application form. 

Please make checks payable to Friends Together United Methodist Preschool (FTUMP).

FOUR AND FIVE YEAR OLDS

_____ Monday/Wednesday/Friday a.m. (8:45 a.m. – 11:30 a.m.)  $85.00 per month*

If the morning class is full, are you interested in an afternoon class

(12:45 p.m.–3:30 p.m.)?   Yes____     No____

THREE YEAR OLDS

______ Tuesday/Thursday a.m. (8:45 a.m.–11:30 a.m.)  $70.00 per month*

*Rates are subject to change with 60 days notice.

FOR OFFICE USE ONLY:

Application received_______________________

Assigned Session_________________________

Fee Paid________________________________