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Tuesday, June 18, 2013

Enrollment Application
Today's Date
Child's Name
Name Child Prefers
Date of Birth
Mother's Name
Father's Name
Address
City
Zip Code
Phone Number
Email Address
Program Preference
Have you previously
had a child attend
St. Luke's Hill?
How did you hear
about St. Luke's Hill?
Please indicate if
directory information
can be included on our
class list
Can we email invoices
and other communication?
Please list the email address(s) that you would correspondence sent to.
Email
Email

A non-refundable registration fee of $50.00 is required with the return of this application.  This fee does not apply towards tuition.  A new application process is required for each school year.  Please make your check payable to St. Luke's Hill Nursery School, and mail it to:

St. Luke's Hill Nursery School
ATTN: Registrar
P.O. Box 453
Fairport, NY 14450
By entering your name into the field below and submiting this form, you understand and agree to all terms and conditions of this application.
Electronic Signature*