Living Savior Preschool Registration Form
Please fill out this form and click submit.
Child's Full Name
*
Child's Date of Birth
*
Child's Home Address
*
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Father's Name
*
Father's Address
*
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AB
AE
AK
AL
AP
AR
AS
AZ
BC
CA
CO
CT
DC
DE
FL
FM
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MB
MD
ME
MH
MI
MN
MO
MP
MS
MT
NB
NC
ND
NE
NH
NJ
NL
NM
NS
NT
NU
NV
NY
OH
OK
ON
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PA
PE
PR
PW
QC
RI
SC
SD
SK
TN
TX
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WA
WI
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WY
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Father's Phone
*
Best Email
*
This address will receive a confirmation email
Mother's Name
*
Mother's Address (if different)
*
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AA
AB
AE
AK
AL
AP
AR
AS
AZ
BC
CA
CO
CT
DC
DE
FL
FM
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MB
MD
ME
MH
MI
MN
MO
MP
MS
MT
NB
NC
ND
NE
NH
NJ
NL
NM
NS
NT
NU
NV
NY
OH
OK
ON
OR
PA
PE
PR
PW
QC
RI
SC
SD
SK
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
YT
Mother's Phone
*
Class Session 8:30am - 11:30am
*
Please select all that apply.
3 days/week [$200/mo]
4 days/week [$265/mo]
5 days/week [$325/mo]
Class Session 8:30am - 3:00pm
*
Please select all that apply.
3 days/week [$400/mo]
4 days/week [$530/mo]
5 days/week [$650/mo]
Desired Days of Week [Class Sessions are limited to 15 children. Filled on first-come, first-served basis.
*
Please select all that apply.
Monday
Tuesday
Wednesday
Thursday
Friday
Registration Fee is non-refundable. Make check to: Living Savior Lutheran Church.
Registration Fee ($50)
Monthly Payment ($)
Registration Fee ($50)
Monthly Payment ($)
Amount
Questions? Contact April Best 406.240.0625 or visit livingsaviormissoula.org - Preschool Link
Credit/Debit Card Number
Expiration Date/CVC
Name on Card
Card Billing Address
AA
AB
AE
AK
AL
AP
AR
AS
AZ
BC
CA
CO
CT
DC
DE
FL
FM
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MB
MD
ME
MH
MI
MN
MO
MP
MS
MT
NB
NC
ND
NE
NH
NJ
NL
NM
NS
NT
NU
NV
NY
OH
OK
ON
OR
PA
PE
PR
PW
QC
RI
SC
SD
SK
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
YT
Submit
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