Enrollment Application Form - Silver Park - PRIMEROS PASOS - Silver Park Campus

Enrollment Application Form - Silver Park Campus

Please note:
A non-refundable $75 Application Fee is required at the time of application, waived for voucher tuition families. We will automatically enter application into all classes that match your child's birth date. We will keep it on file for as long as your child is age-appropriate for any of our programs. We will notify you as soon as an opening becomes available in the appropriate class. An application does not guarantee admission. Thank you.

Primeros Pasos, Silver Park Campus Location
901 Bayshore Blvd.
San Francisco, CA
Tel. (415) 655-9491
Email: director@primerospasossf.com

Child/Children's Information

* Indicates required field

Child's Name (1) *

First

Last

CHILD'S NAME (2) *

First

Last

Child's Date of Birth (1) *

Child's Date of Birth (2) (If Applying) *

Please call my child/children by this name: *

Non-applicant sibling(s), if applicable *

Birth date and School *

Did any family member attend Primeros Pasos, who and when? *

Child /Children's Home Address *

Line 1

Line 2

City

State

Zip Code

Country

Parent Information

Name, Last Name (Parent 1) *

First

Last

Name, Last Name (Parent 2) *

First

Last

Email (Parent 1) *

Email (Parent 2) *

Phone Number (Parent 1) *

Occupation (Parent 1) *

Employer (Parent 1) *

Languages spoken (level)? (Parent 1) *

Culture(s) of Origin / Influence (Parent 1) *

Address (Parent 1) *

Line 1

Line 2

City

State

Zip Code

Country

Phone Number (Parent 2) *

Occupation (Parent 2) *

Employer (Parent 2) *

Languages spoken (level)? (Parent 2) *

Culture(s) of Origin / Influence (Parent 2) *

Address (Parent 2, if different) *

Line 1

Line 2

City

State

Zip Code

Country

Which ADDRESS would you like correspondence sent to: *

If separated, who is the custodial parent/guardian? *

If separated, what are the custody arrangements? *

Previous Childcare Information

Other adult/children that live with the child, and/or who provides care for the child, indicate the relationship: *

Please list any prior childcare (including nanny), daycare or preschool and ages attended: *

Please indicate any significant health or socio-emotional factors that we should know about your child: *

Please indicate any special abilities or special needs that we should be aware of: *

Please indicate any food / animal / medication allergies that we should be aware of: *

If your family will be using Chldren's Council voucher for tuition payment, please confirm current eligibility: *

HOW DID YOU HEAR ABOUT US? IF YOU WERE REFERRED TO US, WHOM MAY WE THANK FOR THE REFERRAL? *

Please indicate any post-interview thoughts why you would like your family to join the Primeros Pasos community: *

Both Primeros Pasos and it's community treasures our families' diversity. Please indicate whether you are willing to celebrate / share your time and personal / cultural treasure in the classroom or at a parent event? *

Centro Primeros Pasos Programs

Please note: Centro Primeros Pasos has three age groups: infant (4 months - 24 months); toddler (24 months - approx.) 3.5 years; and preschool (approximately 3.5 years - 5 years not yet enrolled in kindergarten.)

Preferred Starting Date: *

Considerations you would like for us to know regarding your preferred starting date, if any: *

Select class: *

Preferred Schedule: (All schedules are full days.) *

Parent / Guardian (1) INITIALS as Signature, Date *

Parent / Guardian (2) INITIALS as Signature, Date *

I agree to receiving marketing and promotional materials

Submit