Application Payment Form | FCCNurserySchool

FCCNS Registration for 2023-2024

Please complete the registration form below.

ONE FORM PER CHILD.

A $50 nonrefundable registration fee per child/form is required in order for your registration to be complete.

FCCNS offers a limited amount of need-based scholarship for tuition.

Please contact the office for more information.

Thank you for your interest in FCCNS!

Child's Last Name

Child's First Name

Child's Date of Birth

Child's Gender

Child's Nickname (if applicable)

Parent 1 Last Name

Parent 1 First Name

Parent 1 Email

Parent 1 Cell

Parent 2 Last Name

Parent 2 First Name

Child's Street Address

Child's City

Child's State

Child's Zip Code

Class Preference (First Choice)

Class Preference (Second Choice)

Class Preference (Third Choice)

Are you an active member of The First Congregational Church of Darien?

Yes

Is applicant a current student at FCCNS?

Yes

Is applicant a sibling of a past or present FCCNS student?

Yes

Name of Sibling and Years at FCCNS (if not current)

Comments

Your Signature

Fee ($)

$50 FCCNS Application Fee per Child - $50

Thanks for submitting!