APPLE TREE PRESCHOOL – LOTTERY FORM

We are now taking registration for fall of 2009. Please return this form no later than Tuesday, January 27, 2009. The lottery drawing will be held on the morning of Wednesday, January 28, 2009.

Child’s Name:________________________________________________________
Child’s Birthday:______________________________________________________
Home Address:________________________________________________________
City:_________________________State:__________Zip Code:_________________
Home Phone:__________________________________________________________
Work or Cell Phone:_____________________________________________________

Please list First, Second, Third, or Fourth choices.

For 3 year old class: (must be 3 before September 1, 2009)
_____Tuesday – Wednesday A.M. 9:00 – 11:30 A.M.
_____ Thursday – Friday A.M. 9:00 – 11:30 A.M.
_____ Thursday – Friday P.M. 12:30 – 3:00 P.M.

For 4 year old class: (must be 4 before September 1, 2009)
_____ Monday – Tuesday – Wednesday A.M. 9:00 – 11:30 A.M.*
_____ Monday – Tuesday – Wednesday P.M. 12:30 – 3:00 P.M.
_____ Thursday – Friday A.M. 9:00 – 11:30 A.M.
_____ Thursday – Friday P.M. 12:30 – 3:00 P.M.
*This class is already full since current students sign up early.

Parent/Guardian Signature
____________________________________

_____$75.00 registration fee (Do not pay this until you have been notified that your
child is officially enrolled in a class.) This fee is non-refundable and must be
paid within 10 days of acceptance in a class.

*If you have had other children who have attended Apple Tree, please write sibling on the top of this form.

Mail form to Apple Tree Preschool; 24020 W. Fraser Rd.; Plainfield, Illinois 60586, e-mail it to Apple.Tree@Plainfielducc.org or fax it to 815-436-0289