IUMC Preschool Registration Form
2008-2009 School Year
Please print out and complete one registration form for each child you wish to enroll. You may, however, combine payments.
Register for: (check one) Registration Fee* 1st Semester Equipment Fee
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T/Th am class _____Bunny $30.00 $15.00
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M/W/F am classes _____Teddy Bear $30.00 $25.00
_____Butterfly
_____Penguin
_____Dolphin
_____Panda
_____Turtle
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M/W/F full day class _____Owl $30.00 $35.00
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*Remember, only one $30.00 registration fee is required per family.
Total Amount Enclosed: __________________________
(registration fee + 1st sem. equipment fee)
Child's Name: __________________________________________________________________________
Birthdate: _________________________ Home Phone: ________________________________________
Parent's Name: _________________________________________________________________________
Home Address: ________________________________________________________________________
City, State, Zip: _______________________________________________________________________
Please complete this form and return it, with your initial payment to:
IUMC Preschool
30 N. Audubon Road
Indianapolis, IN 46219