Preschool Registration Payment

Required

Namerequired

First Name

Last Name

Email Addressrequired

Name of Student(s)required

Number of Childrenrequired

One Child ($160.00)

Two Children ($320.00)

Three Children ($480.00)

Emailrequired

Provide an email address for the receipt.

Please select a payment typerequired

Card

Billing Addressrequired

Address

City

State/Province

Country

Zip/Postal Code

Cardholder Namerequired

First

Last

Expirationrequired

Month

Year