Enrollment Application Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Child(ren) InformationName of Child *FirstLastGender *MaleFemaleDate of Birth *Name of Second Child (if applicable)FirstLastDate of BirthGenderMaleFemaleParent InformationName of Parent/Guardian *FirstLastPhone *Email *Name of Parent/GuardianFirstLastPhoneEmailAddress *Address Line 1Address Line 2City— Select state —AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeHow did you learn about Early Childhood School of Georgetown? *Program InformationDesired Program (please check all applicable): *InfantToddlerPreschoolPre-kDesired Days: *MondayTuesdayWednesdayThursdayFridayDesired Attendance: *8:30 AM – 4:30 PM7:00 AM – 5:00 PM (10 hour day)7:30 AM – 5:30 PM (10 hour day)By checking here, I understand that this information is processed once the $75 application fee is received with the enrollment information. Once availability is determined, you will be contacted about a tuition quote and start date. A one-month non-refundable deposit is due once we confirm availability. Deposit is applied to your last month. *I agreeRequested Start Date: *Submit