Noah Ark Preschool Enrollment Application
We are thrilled that you have chosen Noah's Ark Preschool for your child.
We are looking forward to getting to know you.
I want to enroll my child in:
Child's Information
, MN
Child's Birthday
Has your chid attended pre-school screening?
What elementary school will/does your child attend?
What School District do you live in?
Father
, MN
Mother
, MN
Other Children in family
I need to create or update other children in my family
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I need to create or update my emergency contacts
Emergency Contacts - State of MN requires 2 contacts
Cannot be either parent !!!
Optional...Other people authorized to pick up child from preschool
Parents are automatically authorized!
I need to create or update my child's allergies
Allergies
I need to create or update my child's medical clinics
Source of Medical Care (Clinic)
Source of Dental Care (Clinic)
Source of Hospital
For emergency purposes, the closest hospital, Unity Hospital, will be used.
For non-emergencies, the parents choice below will be used.
Child's Emotional Behavior
Is s/he

OK to select more than one
Is s/he

OK to select more than one
Are there any persons other than parents and siblings in the home?
Are there any cultural or religious customs that you would like to share with us?
Day Care
Social Development
Has child had previous group experience?
If yes, where?
Does s/he get along well with other children?
What do you expect for your child at preschool?
Religious Information
Child attends Sunday School?
If other
Name of church MOTHER atttends
Mother active?
If other
Father active?
Name of church FATHER atttends

Enrollment Summer Term 2022

Summer 22 Half Days (9:00AM to 12:30PM)

Summer 22 Full Days (9:00AM to 3:30PM)

AND / OR

* Add BeforeCare and/or AfterCare

Before Care
After Care

Enrollment in the 2021-2022 Preschool Year (This Preschool Year)

Full Day Child Care (9:00AM to 3:30PM)

Half Day Child Care (9:00AM to 12:30PM)

AND / OR

* Add Before Care and/or After Care

After Care
Before Care

and/or

Enrollment in the 2022-2023 Preschool Year -- starts in September '22

Half Day Child Care (9:00AM to 12:30PM)

Full Day Child Care (9:00AM to 3:30PM)

AND / OR

* Add BeforeCare and/or AfterCare

After Care
Before Care

and/or

Enrollment in the Centennial District Busing Before School and / or After School

After School Care
Before School Care

and/or

Centennial District provides bus transportation to or from your child's school
Not available for Centerville Elementary

Did another parent refer you to Noah's Ark?
Referral Information
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