Intake form

Help us serve you better

Name *

Email address *

What is your child's age?

Which learning level are you interested in?

Please select at least one option.

Creative Thinkers (under age 4)

Bright Builders (ages 4-5)

Readers & Makers (ages 5-7)

What are your preferred class days?

Please select at least one option.

Monday

Tuesday

Wednesday

Thursday

Friday

What is your preferred class time?

Please describe any specific needs or interests your child has.

Additional questions or comments

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Penholic Academy