Intent to Re-enroll/ Priority Registration

2018-19 Family Lyceum
Intent to Re-Enroll/Priority Registration Form

* Indicates required field

Parent Name *

First

Last

Parent Email *

Parent Cell Number *

Student Name 1 *

First

Last

Student 1 Birth Month *

Birth Day (1) *

Birth Year (1) *

Core Class Choice 1 *

Additional Student 2 *

First

Last

Student 2 Birth Month *

Birth Day (2) *

Birth Year (2) *

Core Class Choice 2 *

Additional Student 3 *

First

Last

Core Class Choice 3 *

Student 3 Birth Month *

Birth Day (3) *

Birth Year (3) *

Tuition, dates, & other details will be determined based on interest.

Additional classes we are considering for the 2018-19 school year. Please mark those that interest your family. *

FIREFLY Class (ages 4-5) held mornings 9-11:30. EMBER Extra Class (Friday Mornings 9-11:30)

Comment *

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