Loading Form

Please Wait...


Petits Poussins Brooklyn

Bilingual French Pre-school1656 Third Ave., New York, NY 10128 Tel/Fax: 212-410-0180

APPLICATION: ONE-TIME FAMILY FEE: $200.00

Your child must be 2.0 years old and toilet trained by Sep. 1st to be accepted in the program.


Please Enter Academic Year Here
Please Enter Ideal Start Date Here
Please Enter Child's Name Here
Please Enter Date of Birth Here
Please Enter Place of Birth Here
Please Enter Street Address Here
Please Enter City Here
Please Enter Zip Code Here

Guardian 1

Please Choose an option
Please Enter Guardian Name Here
Please Enter Cell Number Here
Please Enter Email Address Here

Guardian 2

In case of an emergency, who can we call if we are unable to reach you

Please Enter Name Here
Enter Phone Here

September - June




Please Select an option




Please Select an option




Please Select an option




Please Select an option

Medical Statements and Consent

Arc-En-Ciel is not permitted to administer any medication, if needed, please do so at home or after school.

I (we) authorize staff and Director of Arc-En-Ciel Preschool to obtain all necessary Emergency Medical treatment, in case of an emergency.

Please Check if you agree
Please Enter Initials Here

Note: All allergies/medical conditions must be stated on the child's medical form. Additionally, a "Standing Order" from the Pediatrician will be required in order to administer an Epi-Pen, Benadryl, or any Asthma medication. Your child will not be admitted without it.

New York department of health requires that all children are vaccinated for school entrance.

I, hereby, authorize Arc-En-Ciel Preschool to provide care for my child.

Please Check if you agree

I declare to the best of my knowledge that all statements made in this application are true.

Please Check if you agree
Please Enter Name Here
Please provide a valid amount
Please enter payment details



Please enter your card number.
Please enter your name.
Please enter your card expiry date.
Please enter your card security code (CVV/CVC).
Total: