CLA Contact Form
Hello and thank you for your interest in our Preschool! Please complete the information below for an opportunity to be a part of our CLA family!
Child's Information
Child's Name
*
First Name
Middle Name
Last Name
Date of Birth
*
-
Month
-
Day
Year
Date
Child's Age
2 years old
3 years old
4-5 years old
Gender
*
Female
Male
Potty trained?
*
Please Select
Yes
No
In Progress
*Scholars 3 and older MUST be fully potty trained. *
ANY MEDICAL CONCERNS?
*
Patents/Guardian Contact Information
Name
*
First Name
Last Name
Email
*
example@example.com
Relationship
*
Mother, Father, etc
Mobile Phone Number
*
Please enter a valid phone number.
Work Phone Number
*
Please enter a valid phone number.
Thank you so much, we will contact you during the months of enrollment!
How did you hear about us?
*
Contact Us: Phone: 225-459-8245 Email:Director@christoff'slearningacademy.org
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