ELLI Lab School – Registration Form

Completion of registration form does not guarantee enrollment. A registration fee and deposit are due upon acceptance to the program.
 
For more information, please call 203 899 0606, ext. 216.
 
* Indicates Response Required

STUDENT INFORMATION
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PARENT/GUARDIAN 1

PARENT/GUARDIAN 2
Please include if address, phone number or email is different from above.

EMERGENCY CONTACT INFORMATION
In the event a parent/guardian cannot be reached, please provide an emergency contact person and the best number to reach them.

SCHEDULE
Select your Time preference for Full Day or Extended Day (AM or PM). If your choice is unavailable, you will be placed on a wait list.

ADDITIONAL INFORMATION
1) Does your child have any special needs, restrictions or allergies that Stepping Stones should be aware of while s/he is in our care? *
0/500 characters
2) Has your child ever attended a preschool or daycare? *
0/300 characters


APPLICATION AGREEMENT
Please check each statement and sign at the bottom of the application to indicate you have read and understand the terms of the application. *
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Please submit this application online or by email or mail to:

Stepping Stones Museum for Children, ELLI Lab School
Mathews Park, 303 West Avenue, Norwalk, CT 06850
or ellilabschool@steppingstonesmuseum.org.

For more information, please call 203 899 0606, ext. 247.

Completion of registration form does not guarantee enrollment.
A registration fee and deposit is due upon acceptance to the program.

Stepping Stones Museum for Children is a non-profit 501 (c)(3) organization. All application and tuition fees go to teacher salaries, materials and programming and building/facilities maintenance.