Child's Name
*
First Name
Last Name
Child's Birthday
*
MM
DD
YYYY
Parent/Guardian #1 Name
*
Who is your preferred point of contact?
First Name
Last Name
Parent/Guardian #1 Profession/Place of Work:
*
Parent #1 Email
*
Phone
(###)
###
####
Parent/Guardian #2 Name
First Name
Last Name
Parent/Guardian #2 Profession/Place of Work:
Parent #2 Email
In what town/city does your family reside?
*
If you would like to share any unique information about your child you want caregivers to know, you may do so here:
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Ex. allergies, dietary restrictions, special needs, etc.
If you'd like to share more about your child's home life, you may do so here:
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Ex. Siblings, pets, primary caregivers, schedule, current enrollment in another program, special interests of child, etc.
Please describe your child's previous experience in any kind of care outside the home:
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Ex. Daycare, preschool, nannyshare, babysitter, family members, none, etc.
Is your child's immunization record up to date and available if enrollment is offered? (This is a state requirement for all daycares and preschools.)
*
How did you hear about Miss Audrey's?
*
Please select your preferred program(s) below.
*
If you have flexibility with the above program preferences, please elaborate below.
Submission Date
*
Please use TODAY'S DATE.
MM
DD
YYYY
Please remember send your $80 application fee to @Miss-Audrey via Venmo to complete your submission.
Applications submitted without payment will not be processed.
Tours are available when a spot is open or is anticipated to open.
