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* Required Information

Parent(s) Name(s): *

Childs Full Name(s): *

Childs Birth Day: *

Email: *

Phone/Cell Number: *

Please Check The Program You Are Interested In: *

Infant/Toddler Program
Preschool Program
Pre-Kinder Program

State the Day(s) you need:
Minimum Days Required 4/5 days *


Select Time And Schedules: *

Before School Program-7:30am -8:30am
Half Day- 8:45am-12:45pm
Full Day- 8:45am-3:45pm
After School Program-4:00pm -5:30pm

Additional Notes:

Terms And Conditions: *

I understand that filling out this intake form does not guarantee admission. To apply, a separate application must be filled out.

Please fill in the word below in the box: *

Join Little Einsteins Spanish School

If anything is unclear or you need help,
just call or email us below:

(503) 998-1422
(503) 629-0477