Enrollment/ Wait List Application

Number of Children*

Child's Name*

First Last

Child's Date of Birth*

MM

DD

YYYY

Class Preference: Please Check One of the Following

T/Th Nursery/ Preschool – 2 years old by 9/01
MWF Nursery/ Preschool- 2 years old by 9/01
5 Day Nursery/ Preschool- 3 years old by 9/01
TK - 4 years old by 9/01
Kindergarten- 5 years old by 9/01

Please Check One*

Boy
Girl

Child's Name*

First Last

Child's Date of Birth*

MM

DD

YYYY

Class Preference: Please Check One of the Following

T/Th Nursery/ Preschool – 3 years old by 9/01
MWF Nursery/ Preschool - 3 years old by 9/01
5 Day Nursery/ Preschool - 3 years old by 9/01
TK - 4 years old by 9/01
Kindergarten- 5 years old by 9/01

Please Check One*

Boy
Girl

Child's Name*

First Last

Child's Date of Birth*

MM

DD

YYYY

Class Preference: Please Check One of the Following

T/Th Nursery/ Preschool – 3 years old by 9/01
MWF Nursery/ Preschool- 3 years old by 9/01
5 Day Nursery/ Preschool- 3 years old by 9/01
TK - 4 years old by 9/01
Kindergarten- 5 years old by 9/01

Please Check One*

Boy
Girl

Member of St. James Church*

Yes
No

First Parent Name*

First Last

Second Parent Name*

First Last

Home Address*

Street Address Address Line 2 City ZIP Code

Phone Number*

Email*

Name of Sibling who attended St. James

First Last

Year(s) sibling attended St. James

(Example: 2010-2011) *Attending Summer School only does not earn sibling status.

Upon submission, you will be taken to PayPal to complete the transaction. You can use credit card or your PayPal account.

Wait List Application Payment - Collected Upon Submission*

Price: $50.00

Wait List Application Payment - Collected Upon Submission*

Price: $100.00

Wait List Application Payment - Collected Upon Submission*

Price: $150.00