APPS MEMBERSHIP APPLICATION    School Year: 2008-2009 ……………….……

ALMADEN PARENTS’ PRE-SCHOOL 5805 Cahalan Avenue San Jose, Ca  95123 (408) 225-7211 www.appsonline.org

Program Desired 1^St Choice 2 -Day 3-Day 4-Day Two-Timers TH PM Circle one

Program Desired 2^nd Choice 2-Day 3-Day 4-Day Two-Timers TH PM Circle one

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Child’s First Name                               Last Name                             Birth Date                              Sex

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Home Address                     City                         State       Zip                          Telephone #                        E-mail

E-mail is used to communicate with members. Do you have difficulty receiving e-mail ?  Yes   No

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Father’s First Name             Last Name           Occupation                              Work Telephone#               E-mail

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Mother’s First Name           Last Name           Occupation                             Work Telephone #             E-mail

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Child’s Physician                                                                                                                                                 Telephone #

Where did you learn about Almaden Parents’ Pre-school?………………………………………………………………………

If you were referred by someone, who referred you?…………………………………………………………………………….

Are you an alumnus of Almaden Parents’ Pre-School?…………………………………………………………………………

If you are a returning parent, what school year did you begin APPS, including Two-Timers?……………………………

Have you been attending consecutively since you began?………………………………………………………………… 

Dated………………………………………..Signature of Parent………………………………………………………………

Almaden Parents’ Pre-school admits students of all races, religious and national origins.

Priority is determined by the date you return this application
with your non-refundable application fee, which is $35 per family.

Please make your checks payable
to Almaden Parents’ Pre-school and return to the Membership Chairperson listed below:

Kristin Gordon | 224 Prague Drive | San Jose, CA 95119 | (408) 225-3045

For Office Use Only:

Date Rec’d……………Enroll Fee………St.Date………………Notice…………….Last Day…………………..