Application Payment Form | FCCNurserySchool

FCCNS Registration for 2022-2023

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.

Thank you for your interest in FCCNS!

Primary Guardian Last Name

Primary Guardian Email

Child's Last Name

Child's Nickname (if applicable)

Primary Guardian First Name

Primary Guardian Cell

Child's First Name

Child's Gender

Child's Date of Birth

Child's Street Address

Child's State

Child's City

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

Comments

Your Signature

Fee ($)

$50 FCCNS Application Fee per Child - $50

Thanks for submitting!