Enrollment Form

    702 NE Norton Ave. Bend OR 541-389-5475 e-mail:
    office@circleoffriendsbend.com

    Childs Name (required)
    Birth Date (required)
    Birth Place (required)

    Morning Program Selection


    Blue Bell NurseryMorning Glory PreschoolRed Rose Pre-k/KindergartenAftercare


    Full TimePart Time


    MTWTHF
    3, 4 or 5 day options (M or F required for 3 day slot)

    Before and Aftercare Needs:



    (days/times if known)

    Information About The Family










    _________________________________________

    Emergency Contact Persons (In case the parents cannot be reached)




    _________________________________________

    Other Information

    List people, other than parents, to whom your child may be released on a
    regular basis:

    _________________________________________

    Medical Information


    I Agree that Circle Of Friends Preschool can use this submitted information to enroll my child.


    To Register: Please fill out this form completely and submit with yearly

    Registration Fee of $ 100.00 (make checks to Circle of Friends)

    Questions? Just call the school at 541 389-5475 Thanks!

    Circle of Friends admits students of any race, creed, physical handicap,
    national or ethnic origin.