JCS Inquiry Form

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Parent/Guardian Name

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Relationship to Child(ren)

Mother
Father
Guardian
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Child's Name

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Child's Age

Child's Name

Child's Age
 

Child's Name

Child's Age
 

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Address (Street, City, Zip)

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Phone

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Email

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Anticipated Start Date

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Interested in:

ChildCare   3's Preschool   4's Preschool   1/2 Day Pre-Kindergarten   1/2 Day Kindergarten   All Day Kindergarten   1st-4th Grade   5th-8th Grade   Multiple Grade Levels
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I would like:

Information Packet   Tour   Phone Call   All of the Above
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How did you hear about JCS?

Friend   Family   Church   Website   Radio Ad   Other
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