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Information Packet Request Form

Please fill out and submit this form, and we will mail you our complete information packet, which extensively details Daycroft's educational offerings for your child.

If you prefer, you may call our administrative offices at 734.662.3335 to order the information packet.

All fields are required unless otherwise noted.

Your Child's Name(s), Gender(s) and Birth Date(s) Year of Interest Select a Year 2011-2012 2012-2013 2013-2014 Grade(s) Interested In Preschool - Half Day (5 half-days per week)

Preschool - Full Day (5 full days per week)

Preschool - Flexible (a mix of 5 half and full days per week)

Kindergarten

1st Grade

2nd Grade

3rd Grade

4th Grade

5th Grade

6th Grade

Parent 1 Name Parent 2 Name Address City State Select a State Not Applicable Alabama Alaska Arizona Arkansas California Colorado Connecticut D.C. Delaware Flordia Georgia Hawaii Iowa Idaho Illinois Indiana Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Zip Phone Number Cell Number Email How did you hear about Daycroft? (Check all that apply) Metroparent

Billboards

Website

Word of Mouth

YPT Program

Wild Swan Program

AIMS website

ISACS website

Observer

Local paper (print or online)

Other (please specify below) If 'Other' please specify Optional: Do you have a specific question for us? If so, please note it here.

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