Twos -Thursday 9:15-11:45 $60/ month
Threes-Tuesday/Friday 9:15-11:45 $100/month
AM Fours -Monday/Wednesday/Thursday 9:15-11:45 $120/month
PM Fours-Monday/Tuesday/Thursday 12:30-3:00 $120/month
Pre K-Monday thru Thursday 9:15-11:45 (must be 5 by 1/1) $145/month
Little Lamb Learners Registration Form
Please send a $50 nonrefundable registration check and this completed form to Little Lamb Learners, 135 Quarry Rd, Alburtis, PA 18011 (First tuition payment is due May 15th.)
___Twos -Thursday 9:15-11:45 $60/ month
___Threes-Tuesday/Friday 9:15-11:45 $100/month
___ AM Fours -Monday/Wednesday/Thursday 9:15-11:45 $120/month
___PM Fours-Monday/Tuesday/Thursday 12:30-3:00 $120/month
___Pre K-Monday thru Thursday 9:15-11:45 (must be 5 by 1/1) $145/month
Child’s Name______________________ Nickname____________
Boy/Girl________ Date of Birth____________________________
Home Address__________________________________________
Home Phone______________________Cell____________________
Sibling names & ages___________________________________________
School District___________________ Email________________________
Parent/Guardian’s Information Parent/Guardian’s Information
Name______________________ _________________________
Occupation__________________ _________________________
Employed at_________________ _________________________
Work Phone_________________ _________________________
How did you hear about Little Lamb Learners?_______________________
Is either parent a member of Church of the Good Shepherd?_____________
I would like more information about the church services. Yes____ No_____
Is there any language other than English spoken at home?_______________
Is your child potty trained?______________
List child’s allergies____________________________________________
Has your child ever received services from the IU for speech, behavior, learning support, etc? ___________________________________________
Parent Signature_________________________ Date________________