Application Form for Teddy Bear Academy

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Application Form for Teddy Bear Academy 1. Application Form for Teddy Bear Academy: Step #1 By completing this confidential application form you are taking the first step in the application process for Teddy Bear Academy. It will only take a moment. Thank you. 1. How important is your child's early education to you? j k l m n j k l m n j k l m n j k l m n j k l m n 1 (not important) 2 3 4 5 (very important) Please feel free to add a few thoughts: 2. Applicant's name and home address: Name: Address 1: City/Town: State/Province: ZIP/Postal Code: Email Address: Phone Number: 3. Please identify the applicant and, if appropriate, the co-applicant's relationship to the child: Applicant's relationship: Co-applicant's name: Relationship: Co-applicant's e-mail: 4. Child's full name, if in utero, please indicate accordingly: 5. What is the child's date of birth (actual or anticipated): MM Date of birth (actual or anticipated) / DD / YYYY 6. Requested start date: MM Start date: / DD / YYYY Page 1 Application Form for Teddy Bear Academy 7. What age group is your child's application for based on the requested start date?: j k l m n j k l m n j k l m n Infant (6-18 months) Toddler (18-30 months) Preschool (30-60 months) 8. Desired days: j k l m n j k l m n j k l m n Monday, Tuesday, Wednesday, Thursday, Friday Monday, Wednesday, Friday Tuesday, Thursday 9. How did you hear about Teddy Bear Academy: c d e f g c d e f g c d e f g c d e f g Current parent Flyer Internet Word-of-mouth Other (please specify) 10. What are your expectations of Teddy Bear Academy? The text box supports up to 100 words. 2. Thank You For Your Application Congratulations, you just completed the first step in the application process. The second step requires sending a $50.00 cheque made payable to "Teddy Bear Academy". All cheques are nonrefundable and should be sent to the following address: Teddy Bear Academy 167 High Park Avenue Toronto, ON M6P 2S3 Canada Once the fee has been received Teddy Bear Academy's supervisor will contact you and confirm that you have completed the application process. All information submitted with this registration will remain confidential. We look forward to serving you. Teddy Bear Academy Page 2

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