CHALK Preschool

Child's Information

Child's First Name Child's Last Name Gender

MaleFemale

Date of Birth

Parent/Guardian 1 Information

First Name Last Name Email Address Phone Number Additional Phone Number(Optional) Address Address Line 2(Optional) City State Zip Code

Parent/Guardian 2 Information

First Name Last Name Email Address Phone Number Additional Phone Number(Optional) Address Address Line 2(Optional) City State Zip Code

Schedule

Requested Start Date(Based upon availability) Comments on Flexibility of Days (This is a great opportunity to let us know just how flexible you can be.)

By submitting this enrollment application, the Parent/Guardian above understands and accepts the following policies: The $250 registration fee is non-refundable and non-transferable if the child is accepted into the program. The first month's tuition is due within two weeks of the time a spot is offered, and it is non-refundable and non-transferable.

I Understand and accept the policies.

Enrollment Application

CHALK of Tarzana

Child's Information

Parent/Guardian 1 Information

Parent/Guardian 2 Information

Schedule