Name of your child (first and last name please):  

        Boy     Girl   

        Date of birth: 

        Is your child potty trained?        Yes!        No!

Please request the days you want (days are subject to availability)     

        Tuesday, Thursday   

        Monday, Wednesday & Friday   

        Monday, Tuesday, Wednesday, Thursday & Friday

Name of child # 2 (first and last name please):    

        Boy     Girl  

        Date of birth:  

        Is your child potty trained?        Yes!        No!

Please request the days you want (days are subject to availability)     

        Tuesday, Thursday  

        Monday, Wednesday & Friday   

        Monday, Tuesday, Wednesday, Thursday & Friday

Mothers  name:    

Home phone number:  

Mothers daytime phone number:

Mothers home address: (please include city and zip code) 

Mothers place of employment (name of business): 

Fathers name:      

Home phone number:   Same as Mothers    Different:

Fathers daytime phone number:

(if different than the mother's)

Fathers home address: (please include city and zip code)  

Fathers place of employment (name of business): 

Primary email address:   

Secondary email address:

How did you hear about us?    Word of mouth recommendation I saw your sign at the site. Yellow Pages add The Desert Sun Heard your radio ads

Comment:  Please let us know when you would like your child to begin attending First School Palm Springs.  We will contact you regarding availability.  Please let us know what questions you have and how we can serve you.

Once you submit this form back to us you will be returned back to this page after reviewing the information you send us.  Please download and print the six State of California forms listed below.  Fill out the forms and return them back to First School.