SDSU:Preschool Enrollment Form

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*Child's Name
*Date of Birth
Sex	Female Male

Fathers Name
Street Address
City
State
Zip Code
Home Phone
Work Phone
Email
Mother's Name
Street Address
City
State
Zip Code
Home Phone
Work Phone
Email
Child Lives With (if applicable)
Session Preference	3-4 Four Year Old Morning Preschool 4-5 Four Year Old Morning Preschool 3-4 Four Year Old Afternoon Preschool 4-5 Four Year Old Afternoon Preschool Toddler I (15-24 Months) Tuesday/Thursday Mornings Toddler II (24-36 Months) Monday/Wednesday Mornings

South Dakota State University, Brookings, SD 57007 -- 1-800-952-3541
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