<p> APPLICATION FOR ENROLLMENT – 2016/17</p><p>Please complete the attached form and return it along with the $35 registration fee to Discovery MI Preschool 738 Taylor Ave Scranton PA 18510</p><p>Student’s First Name Student’s surname Date of Birth Age on September 1, Home address</p><p>City State Zip School District</p><p>Mother’s Name Home Address Home Address City State Zip Telephone Cell phone Work Phone</p><p>Father’s Name Home Address Home Address City State Zip Telephone Cell phone Work phone</p><p>Please tick as appropriate I would like to apply for enrollment in the full day program I would like to apply for enrollment in the morning only program I would like to apply for enrollment in the afternoon only program</p><p>Discovery MI Preschool will do its best to accommodate preferences for half day sessions but is unable to guarantee entrance into a particular session until enrolment is complete. </p><p>Discovery MI Preschool 1301 Beech St Scranton PA 18504 www.mydiscoverypreschool.org</p>