St. Mary's Richard Tufenkian Pre-School

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Child's Name
First:	*
Last:	*
Middle:

Child's Birth Date:	*

Name of the Parent/Guardian:	*
Day time Phone #:	* XXX-XXX-XXXX
Alternative Phone #:	XXX-XXX-XXXX
Email Address:	* A confirmation message will be sent to this address.

Does the child have a sibling attending Chamlian / Tufenkian?
Name of the sibling:
Grade/Group:
Are you a Western Prelacy School or Organization employee?
Name of School or Organization:
First & Last Name:
Additional Comments:
Please Note: This application is valid only for one academic year. This application is for waiting list only and does not guarantee an automatic entry in to the preschool. The actual registration for enrollment will take place during the month of April 2010.