Please provide the following information about the child:

Child's Full Name:
Sex:
 Male Female
Date of Birth (mm/dd/yyyy):
Child's Home Address:
City, State, Zip:
Child's Phone Number:
   
Contact Information:  
Father's Name:
Father's Address:
City, State, Zip:
Father's Phone Number:
   
Mother's Name:

Mother's Address:
(if different)

City, State, Zip:
Mother's Phone Number:

Please Choose the Program You are Interested in
(all prices are by the week)

2 1/2 Year Old Program
$140.00
3 Year Old Program
$140.00
4 Year Old Program
$140.00

 

If you have any questions or comments about the form, feel free to enter them here:

 

Little Ones Lutheran School Inc.
7 Bay Vista Rd
Rehoboth Beach, DE 19971
302-226-7860
info@littleonesschool.org

 


This page last updated January 22, 2008

The Little Ones Lutheran School Inc. accepts all children regardless of gender, race, religion, national/ethinc origin.