ACADEMIC YEAR: 2008-2009
1. Student’s Information:
Child last name*: First Name*:
Home address*:  City:  
Home phone: Zip code:
Date of birth:
 Age*:
Gender:
Student:
 
Allergies: P.E. Restrictions:
Entering in the Fall:  
    
   
10460 Slater Avenue, Fountain Valley, CA 92708 - Phone: 714-964-3310 - Fax: 714-964-3753