ADMISSIONS APPLICATION

CHILD’S INFORMATION


Known Allergies

Yes No

If Yes please list or describe:

PARENT’S INFORMATION

EMERGENCY CONTACTS

Emergency Contact Name Tel Name Relationship to child

CHECK BOX FOR CHILDS CLASS AND AGE

Princeton Poodles (0 - 1.5 Years)
Yale Yorkies (1.5 - 3 Years)
Harvard Hounds (2.5 - 4 Months)

DESIRED TIMES

8AM – 6:00 PM Basic
8AM - 6:30 PM Extended Day

PERIOD OF ENROLLMENT

12 Months: September - August
12 Months: (Other)

DESIRED START DATE

Monday

04 Nov 2019
11 Nov 2019

Tuesday

No Slots Available!

Wednesday

No Slots Available!

     

TIME SLOTS


1 to 3