Primary Parent Last Name  * First Name: Email Address: Telephone:   Secondary Parent First and Last Name:   Home Information Address: City: State: Zip Code: Number of children in household: 1 2 3 4   Child 1 First and Last Name Child 1: Birthdate Child 1 (mm/dd/yyyy): If enrolled please select grade level: not enrolled 2011 Kindergarten 2011 1st Grade 2011 2nd Grade 2011 3rd Grade 2011 4th Grade 2011 and beyond   Child 2 First and Last Name Child 2: Birthdate Child 2 (mm/dd/yyyy): If enrolled please select grade level: not enrolled 2011 Kindergarten 2011 1st Grade 2011 2nd Grade 2011 3rd Grade 2011 4th Grade 2011 and beyond   Child 3 First and Last Name Child 3: Birthdate Child 3 (mm/dd/yyyy): If enrolled please select grade level: not enrolled 2011 Kindergarten 2011 1st Grade 2011 2nd Grade 2011 3rd Grade 2011 4th Grade 2011 and beyond   Languages What languages are spoken at home? English German Spanish French Other What are the German language skills for the child(ren) you wish to enroll None Beginner Intermediate Native speaker   Would you like to participate in a German tutoring class or summer camp to expose your child to the German language or strengthen his/her German prior to enrollment? Yes No   Volunteering for ICS I would like to join the following volunteer committee(s): Collecting Signatures Public Relations Location Acquisition Staff Recruitment Grant Writing Fundraising   How did you hear about us? Library Preschool Friend Ad Flyer Newspaper Grocery Store Other   Mailing list signup:   Check this box to signup for our site mailing list. Security code:   * Do not enter anything in this field:

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