Sunshine Academy
Enrollment Interest Form
*Please provide one form per every child*
Hours of operation 6am-6pm
Our Contact Information
1230 Palm Coast Pkwy. NW 170 Old Kings Rd. South
Palm Coast, FL 32137 Flagler Beach, FL 32136
Phone: 386-445-2822 Phone: 386-439-9985
Fax: 386-445-1592 Fax: 386-439-5960
Email: [email protected] Email: [email protected]
Today’s
Date: __________
S tudent information: If you are interested in enrolling 2 or more children, please fill out additional forms. Check here if you have more than 1 child that you are interested in enrolling
Date of Birth: _________________MO/DD/Year Sex: _______
Full name: ____________________________________________________________________________________________
Last First
Parental Information (Contact Person)
Name: _______________________________________________________________
Best Contact Phone Number: ________________________________________________________
Address: ____________________________________________________________________________________________________
How did you hear about us? If Advertisement, Which One? If Referred, By Whom?
_________________________________________________________________________________
Program interested in: (check all that apply) Schedule Interested in:
I nfant (Flagler Only): 6 wks – 12 mos.
T oddler 1+2: 12 mos. - 2 yrs. Full time (up to 10 hours/day 5 days a week, Monday through Friday)
T oddler 3+4: 2 yrs – 3 yrs.
P reschool: 3 yrs - 4 yrs. Part time:
Up to 6 hours/day: 6am-12pm
V PK (Voluntary Pre-K) 9am-3pm
Summer
Fall
B efore and/or after School Up to 3 hours/day: 9am-12pm
S ummer Camp
Part time schedules may run on a 5, 3, or 2 days a week schedule
5 days= Monday through Friday
3 days= Monday/Wednesday/Friday
2 days= Tuesday/Thursday
Notes: (For Sunshine Academy Personnel Use)
CAMP SUNSHINE PACKING LIST HAT OR VISOR SUN PROTECTION
CATCHING SUNSHINE WHAT MATERIALS DO I NEED? COMPUTER EQUIPMENT
COOPERATION ON BIODIVERSITY CONSERVATION IN SUNSHINEMOON RIVER BASIN PROJECT
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