Enrollment Form

    702 NE Norton Ave. Bend OR 541-389-5475 e-mail:

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

    Morning Program Selection

    Blue Bell NurseryMorning Glory PreschoolRed Rose Pre-k/KindergartenAftercare

    Full TimePart Time

    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.