Editing previous response:

Please fix the highlighted areas below before submitting.

St. Michael YMCA Early Learning Application Form

YMCA

HTCSD and St. Michael School are pleased to continue our partnership with YMCA of Regina to offer an Early Learning Program in our school.

All applicants will be contacted by St. Michael administration for an interview before acceptance into the program is given. The cost is currently $200.00 for 5 Half Days per month. The cost is $400.00 for 5 Full days per month.

Please complete the form below. Required fields marked with an asterisk *

Parent Name:*

Answer required for "Parent Name:"

Child's Name:*

Answer required for "Child's Name:"

Child's Date of Birth*

Answer required for "Child's Date of Birth"

Address:*

Answer required for "Address:"

Home Phone:*

Number Required

Cell Phone:

Number Required

Parent email address:*

Answer required for "Parent email address:"

Has your child ever been involved with any outside agencies? (ex: Speech, ECIP, etc)? If yes, please identify:*

Answer required for "Has your child ever been involved with any outside agencies? (ex: Speech, ECIP, etc)? If yes, please identify:"

Will your child be attending Kindergarten at St. Michael School?*

Answer required for "Will your child be attending Kindergarten at St. Michael School?"

Yes

I prefer my child to attend: *

Answer required for "I prefer my child to attend: "

Monday to Friday Mornings Only

Monday to Friday Afternoons Only

Monday to Friday all day ( Full Time)

*Preliminary class schedules will be given to parents in June. However, within the first few months of school changes may be necessary based upon group dynamics and individual student needs.

*By clicking submit, you acknowledge that your information will be sent to Stephanie @ YMCA and HTCSD St. Michael School.