We are currently accepting new submissions for our Wait List. Following the completion of the form below, you will be directed to the online payment page. A $25.00 Wait List fee and separate Wait List Form must be submitted for each child. Once completed, you will receive an email to confirm your payment and placement on the Wait List.

Child's First Name

Child's Last Name

Child's Birthdate

YYYY

Age as of August 31st

Child's Sex

Is your child up to date on his/her immunizations?

Due to California State Law SB276, we must require children attending preschool to complete all immunization requirements prior to registration. https://www.shotsforschool.org/child-care

If 'No', please explain:

Mother's Name

First Name

Last Name

Mother's Phone Number

(###)

###

####

Mother's Email

Father's Name

First Name

Last Name

Father's Phone Number

(###)

###

####

Father's Email

Home Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Desired Start Date

YYYY

Please indicate your desired schedule

Mondays

Tuesdays

Wednesdays

Thursdays

Fridays

Does your child receive any type of special services? (e.g. Physical Therapy, Speech Therapy, Occupational Therapy, etc.)

Is there any additional information that we should know about your child? (e.g. Allergies, Development, Learning Style, etc.)

Are you a member of La Jolla Presbyterian Church?

Have you or anyone in your family attended La Jolla Presbyterian Church Preschool?

Please list their names below:

How did you hear about us?

I understand that joining the Interest List does not guarantee my admission to La Jolla Presbyterian Church Preschool and that the waitlist fee of $25.00 is non-refundable.