Teddy Bear Learning Center™

Teddy Bear Learning Center

11 Middletown-Lincroft Road | Lincroft NJ 07738 | 732-747-8583

Preliminary Visit Information Form

So that we may better help you in selecting a program for your child, please print this page, complete the information requested, and bring it with you to the school upon your visit. To schedule a tour of the school, call 732-747-8583 between 9:00am and 11:00am.

Child's Full Name		Known As
Gender	o Male o Female	Potential Start Date
Previous Group Experience	o Yes o No If YES, indicate where:
Date of Birth		Age as of Sept 1st
Home Phone		Cell Phone
Mother's Name		Father's Name
Home Address
Other Children At Same Address / Age
Other Family Members At Same Address
How did you hear about Teddy Bear Learning Center?	o Yellow Pages o Internet Reference: o Referral, from: o Advertisement: o Other:
List 5 priorities you would like in a preschool.	_________________________________________ _________________________________________ _________________________________________ _________________________________________ _________________________________________