Arka Preschool Parent Inquiry Form
* indicates required question
Primary Email
*
Date Care Needed
Parent's First Name
*
Parent's Last Name
Cell Number
*
Address
Name of Child(ren)
Age of Child(ren)
Is your child currently enrolled in another program?
*
Yes
No
Any special/medical needs we should know about?
*
Yes
No
Any behavioral needs we should know about?
*
Yes
No
If your child is 3 years or older, is he/she fully potty trained (one or fewer accidents a week)?
Yes
No
Does your child require assistance while toileting?
Yes
No
How Did You Hear About Us?
Google
Facebook
Referral
Other
I agree to receive text messages from Arka regarding my child and their updates. I understand I can opt out at any time by replying STOP.
Yes
No
Submit