Noah's Ark Learning Center, Inc.
Application for Enrollment
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Please fill out this application completely. Accurate information is necessary for us to best serve your child. It is your responsibility
to notify us immediately of any changes in employment or residence.
Today's Date: __________
Child's Name: _________________________________________________
(Last Name) (First Name)
Mother's Name: ________________________________________________
(Last Name) (First Name)
Father's Name: ________________________________________________
(Last Name) (First Name)
Address: _____________________________________________________
(Street) (City) (State) (Zip)
Home Phone: (___)____-_____
Child's Birth Date: ____________
Child's Age: ______
About Your Child:
Potty Trained? ______ Allergies? ______ Special Needs?_____________________________
Siblings: Names and Ages __________________________________________________________________
About You:
Mother's Employer: _______________________________________ Work Phone: (_____) ______ - _________
SS#___________________________________ (required)
Employer's Address: _________________________________________________________________________
(Street) (City) (State) (Zip)
Email: ____________________________________________________________________________________
Father's Employer: _______________________________________ Work Phone: (_____) ______ - _________
SS#___________________________________ (required)
Employer's Address: ________________________________________________________________
(Street) (City) (State) (Zip)
Email: ____________________________________________________________________________________
Please include a 2 week Security Deposit and $50.00
non-refundable registration fee with your application. Stop by or
mail application to:
Noah's Ark Learning Center, Inc.
4214 Old Town Rd., Huntingtown, MD 20714
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Noah’s Ark Learning Center, Inc.
Discipline Policy
Noah's Ark has developed the following procedures
regarding discipline. Please know that the majority of our children behave
wonderfully and discipline rarely becomes an issue. A certain testing of
limits is expected and our counselors are adept in correcting minor
behavioral problems. The goal of Noah’s Ark is to help
the children continue to grow and learn appropriate social behavior.
Therefore, our desire is to work with the children, parents, and staff to find the
best solution concerning any behavioral problems.
Should it become necessary to move into formalized steps you will be
advised what behavior is prompting this decision. For those children that
exhibit unusually aggressive, dangerous or persistent misbehavior that is
not corrected, the following steps will be implemented.
STEP ONE: For the first occurrence the teacher will discuss with the child the inappropriate
behavior and the consequences should the behavior continue (steps 2, 3, and 4).
Documentation and signature by all parties.
STEP TWO: Continued inappropriate behavior will require a conference between the child,
the teacher and the Director. Documentation and signature by all parties.
STEP THREE: The parent will be contacted. A conference will be required for the parent, child, teacher,
and Director to discuss the situation. Step Four will be explained to the parent and child.
STEP FOUR: The parent will be notified and the child will be picked up immediately.
This practice will continue until behavior is corrected. Documentation and signature
by all parties.
FIGHTING: If a physical altercation takes place, the children involved will be given a one day
suspension. If a child has three (4) fights in one year (September to August), he will be asked to leave
the Center.
I acknowledge receipt of a copy of the Noah's Ark Discipline Policy and agree to abide by its terms.
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Child’s Name
___________________________________ ____________
Signature of Parent Date