Please remember to use your check's memo line to list your child's name and the program for which you are applying. Applications cannot be processed without the receipt of your child's application fee. Please note our new mailing address: 4977 Glenbrook Road, NW; Washington, DC 20016.

St. David's playgroup
September 17, 2012 – May 10, 2013
Playgroup Hours: Monday-Friday 9:00 a.m. to noon.
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Child

First Name*
Last Name*
Date of Birth*
Male Female
Gender*
Street Address*
City*
State*
ZIP code*
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Parent/Guardian 1

First Name*
Last Name*
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Parent/Guardian 2

First Name
Last Name
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Primary Contact Information

Email Address*
Confirm Email Address*
Home Phone
Work Phone
Cell Phone
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Name of other Caregiver, if applicable

Sibling Names and Ages

Name Age School
How did you hear about Little Graces Playgroup?
Are you a parishioner of St. David's?   
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Non-Refundable Fees

Application Fee:$60 due by April 6, 2012
Remainder of Tuition (please check your first choice):
full-time enrollment
(M–F 9-12)$3,500 due by May 4, 2012
three-day enrollment
(M, W, F 9-12)$3,200 due by May 4, 2012
two-day enrollment
(T, Th 9-12)$2,800 due by May 4, 2012

*required information

Please make your check out to:

Little Graces Playgroup

And mail to:

Little Graces Playgroup

c/o Sharon Amorosi

4977 Glenbrook Road, NW

Washington, DC 20016

Note: No applications will be processed until the $60 application fee has been received.