Students & Mothers In Learning Experiences
SMILE
http://www.smilehomeschoolers.com
$50 For PreK & School Aged Children, $25 3-4 Yr Old Preschool, Free Nursery

First Child's Information

* First Name

* Last Name

* Birth Date

Hour 1 Class

Hour 2 Class

Second Child's Information

First Name

Last Name

Birth Date

Hour 1 Class

Hour 2 Class

Third Child's Information

First Name

Last Name

Birth Date

Hour 1 Class

Hour 2 Class

Fourth Child's Information

First Name

Last Name

Birth Date

Hour 1 Class

Hour 2 Class

Fifth Child's Information

First Name

Last Name

Birth Date

Hour 1 Class

Hour 2 Class

Sixth Child's Information

First Name

Last Name

Birth Date

Hour 1 Class

Hour 2 Class

Parent's Information

* Father & Mother's Name

* Last Name

* Address 1

* City

* State

* Zip

* Phone

Cell Phone

* Email Address

* Indicates Response Required