Thank you for your interest in Goldenwings Academy. To ensure space availability, please submit the following form. If you have any questions or comments you may write them in the space provided. You will be contacted by our administration staff to answer any questions or concerns you might have. NAME: First Name: Last Name: ADDRESS: Street Address: City: State: Zip: CONTACT INFORMATION: Day Phone: From: Select: 6:00 AM 6:30 AM 7:00 AM 7:30 AM 8:00 AM 8:30 AM 9:30 AM 10:00 AM 10:30 AM 11:00 AM 11:30 AM 12:00 PM 12:30 PM 1:00 PM 1:30 PM 2:00 PM 2:30 PM 3:00 PM 3:30 PM 4:00 PM 4:30 PM 5:00 PM 5:30 PM To: Select: 1:00 PM 1:30 PM 2:00 PM 2:30 PM 3:00 PM 3:30 PM 4:00 PM 4:30 PM 5:00 PM 5:30 PM 6:00 PM Evening Phone: From: Select: 5:30 PM 6:00 PM 6:30 PM 7:00 PM 7:30 PM 8:00 PM To: Select: 7:00 PM 7:30 PM 8:00 PM 8:30 PM 9:00 PM 9:30 PM 10:00 PM 10:30 PM Email Address: CHILD INFORMATION: Child's Name: Child's Age: Month: Select: Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Day: Select: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Year Born: Select: 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 Before 1985 SCHEDULING: Tell us about your desired schedule:
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