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9. Requested Program (choose one): *

Infant Program (6 weeks-23 months) 7:30am-5:30p

Toddler Program (2 years) 7:30a-5:30p

Toddler Half Day Program (2 years) 7:30a-12:30p

Preschool Program (3-5 years) 7:30a-5:30p

Preschool Half Day Program (3-5 years) 7:30a-12:30p

11. Requested enrollment date: *

12. Tuition Payments: *

Private Pay

CRC/Solano Family Services

Military Subsidy

13. Child's age at enrollment: *

Additional Info

6. Second Parent's Email: *

10. Schedule Requested: *

Monday - Friday

Monday/Wednesday/Friday

Tuesday/Thursday

16. LPE is proud to offer our families need-based Tuition Assistance on a sliding scale. Please check the box below if you would like to receive our Financial Aid Application:

Please send me the Financial Aid application. I understand that the application is through a 3rd party agency and there will be a $60 application fee if I choose to apply.

15. Do you have any any concerns for your child surrounding of the following? *

Speech Delay

Motor Delay

Developmental Delay

Autism

Other (please detail below)

No concerns at this time

7. Child's Name: *

4. Second Parent's Name: *

3. Email: *

1. Parent's Name: *

8. Child's birth date (or due date): *

2. Phone number: *

5. Second Parent's Phone Number: *

contact info