Enrollment form - Right Steps™ Education

Enrollment Form

Enrollment Application
Childs Name*
Date of Birth*
Primary Address*
Country
Pick one of our locations*
Email*
Parent / Guardian Name
Work Phone
Home Phone
Siblings
Name
Age
Schedule Requested
Schedule Requested
- Full Day (Drop off after TIME, Pick up before TIME)
- Part Day (Drop of after TIME, Pick up before TIME). Rittenhouse Square only*
- Before School (Drop off after TIME). Richboro only*
- After School (Arrives after school, Pick up before TIME). Richboro only*
Days Requested
- Monday
- Tuesday
- Wednesday
- Thursday
- Friday
Estimated Drop off time:

: HH

MM
Estimated Pick up time:

: HH

MM
I would like my child to begin:
Verification
Please enter any two digits with no spaces (Example: 12)*
Please enter a value between 0 and 99.
CAPTCHA