Registration for Early Childhood Classes

The Little Dutchmen Preschool-Edgerton Public Schools-Fall 2016

School Readiness-3s Class (Children must be 3 years old by September 1, 2016)--$250 per
semester (Tuition cost is based on 2015-2016 school year. The school board will evaluate costs
in July 2016.) This class will be on Tuesdays and Thursdays. There is only a morning class.
School Readiness-4s Class (Children must be 4 years old by September 1, 2016)--$300 per
semester (Tuition cost is based on 2015-2016 school year. The school board will evaluate costs
in July 2016.) This class will be on Mondays, Wednesdays, and Fridays. There will be a morning
and an afternoon class.
Childs Information:
First Name: _________________________

Middle Name: _______________________

Last Name: __________________________

Nickname: _________________________

Gender: ___________ Birth Date: __________________ Age by September 1, 2016: _______

Parent Information:
Fathers Name: ______________________

Mothers Name: _____________________

Address: ____________________________

Address: ____________________________

City/State: __________________________

City/State: __________________________

Zip Code: ___________________________

Zip Code: ___________________________

Telephone: __________________________

Telephone: __________________________

Email Address: _______________________

Email Address: ______________________

I am registering my child for:

____ 3s Class-My child will be 3 by September 1, 2016
____ 4s Class-My child will be 4 by September 1, 2016
I prefer AM class_____ I prefer PM class _____ No Preference_____
This will not determine which class your child is in. It will be based off of the number of
children enrolled and when your childs registration form is returned.
My child will carpool with: _______________________________________________________
Return registration form to Nikki Windschitl at:
Edgerton Public Schools
PO Box 28
Edgerton, MN 56128

For Office Use Only-Date: _____________