First Congo Nursery School

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A play-based parent participation program for 2, 3 & 4 year-olds

Wait List Form

Online Waitlist Application & Fee Form

Thank you for your interest in our program. To place your child on our waiting list, please complete this form and submit your payment of $20 per child.

Please be aware that this is only for placing your child onto our wait list. This not guaranteeing admittance into our school as a student.

Child's Name
First Last
Child's Date of Birth
Date Format: MM slash DD slash YYYY
Gender (Optional)
- Female
- Male
Do you want to put another child on the waiting list?
- Yes
- No
Second Child's Name
First Last
Second Child's Date of Birth
Date Format: MM slash DD slash YYYY
Second Child's Sex
- Female
- Male
Third Child's Name
First Last
Third Child's Date of Birth
Date Format: MM slash DD slash YYYY
Third Child's Sex
- Female
- Male
Fourth Child's Name
First Last
Fourth Child's Date of Birth
Date Format: MM slash DD slash YYYY
Fourth Child's Sex
- Female
- Male
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Parent/Guardian's Name
First Last
Parent/Guardian's Email
Contact Number other than home (Work/Cell)
Additional Parent/Guardian's Name
First Last
Additional Parent/Guardian's Email
Contact Number other than home (Work/Cell)
Are you a
- A family that has children currently enrolled (a continuing family)
- A church member in good standing of the First Congregational Church of Palo Alto
- A new family
- An alumni from one of our programs
Full Name of Alum and year of exit.
How did you learn about our school?
How many children have you placed on the waiting list?
Total
$0.00
Credit Card*

American Express
Discover
MasterCard
Visa
Card Number Expiration Date Security Code Cardholder Name
Comments
This field is for validation purposes and should be left unchanged.

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First Congo Nursery School
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1985 Louis Road, Palo Alto, CA 94303 • 650-493-1915
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