Jasper United Methodist Church Preschool

Application for Admission

PreSchool 2026-2027

Step 1 of 2

Please complete all questions. The Form will not allow you to move to a new section until all (Required) questions are answered.

Registration Fee $100.00 Activity Fee $50.00

Please Select(Required)
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⚠️ This class is currently full. If you’d like to join the waitlist, please complete the fields below and click the submit button.
Parent/ Guardian Name
Child's Name

MM slash DD slash YYYY
Children must be of age by September 1st for the class they are entering. Children entering the 3 year old classes should be fully potty trained.
Gender: Male or Female(Required)
Child's Living Arrangements(Required)
Child's Primary Address (including city and Zip code)(Required)
Father's Name
Father's Address (if different from child)
Mother's First and Last Name
Mother's Address (if different from child)
Emergency Contacts/Authorized Individuals To Whom Child May Be Released. You may list up to 6 individuals. Please include phone numbers.
click the + sign to add another individual (add up to 6 individuals)
Name
Phone Number