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Enroll Today!

If you are interested in enrolling your child in our preschool please complete
the online form below and someone from our school will be in touch.
* = required field.

Child Information

Child's Name: *

Gender: *

Date of Birth: *

Enrollment Date: *

Home Phone #: *

Address: *

City: *

State: *

Zip Code: *

Age Group: *

Parent/Guardian Information

Child Lives With: *
Both ParentsMotherFatherGuardian

Mother's Name: *

Mother's Work #: *

Mother's Cell #: *

Mother's Email: *

Father's Name: *

Father's Work #: *

Father's Cell #: *

Father's Email: *

Person(s) permitted to remove child
from Preschool Facility:

**Any individual permitted to remove child from PCACC must set up their profile in our enhanced security system, a touch screen/fingerprint scan.

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