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Please return postmarked by August 31 for the Fall session and by
February 1 for the Spring session.
Write check and mail to:
St. Matthew Lutheran School PPH
818 W. Wisconsin Ave.
Oconomowoc, WI 53066
Parent's Name:_______________________________________________________
Parent's Address:____________________________________________________
_____________________________________________________________________
Home Phone Number:___________________________________________________
Who will be bringing the child(ren) to Preschool Power Hour?
_____________________________________________________________________
Address and telephone if different than parents:______________________
_____________________________________________________________________
Names and ages of all children 0-4 yrs who will be attending PPH
(Please include infant siblings)
Name:_____________________________ Name:_____________________________
Name:_____________________________ Name:_____________________________
Name:_____________________________ Name:_____________________________
Cost is $10.00 per child per session (18 mos.-4yrs. only). Infant
siblings are welcome to attend at no cost.
____ number of children x $10 = $________
How did you hear about our program?
Newspaper_____ Friend_____ Brochure_____ Other (specify)_____________