Shepherd's Way Day School

If you are interested in enrolling at Shepherd's Way Day School please fill in the form below. A staff member will contact you concerning availability of space. If we all spaces are occupied, you will be added to our waiting list.

Name:
Email Address:
Confirm Email Address:

Phone Number: HOME (ex. 999-999-9999)
Phone Number: WORK (ex. 999-999-9999)
Phone Number: CELL   (ex. 999-999-9999)

Child's Name:
       and DOB:

Child's Name:
       and DOB:

Please indicate the type of care you need:
     Part Time: Tuesday/Thursday
     Part Time: Monday/Wednesday/Friday
     Full Time
     School-Age (Before/After School)
     Summer Camp

**Once enrolled in any of our part-time programs, these parents have first priority for full-time care (if full-time is needed).

When do you need care?

Questions or Comments:

**Please call bi-monthly to update your information.

SPACE is based on AVAILABILITY

If you prefer to mail your information, please print the form (this is a PDF file and requires Acrobat Reader download here for free),
fill it in completely and mail or fax to:

Shepherd's Way Day School
1575 John Knox Drive
Colfax, NC 27235

or

fax to 336-665-5008

If you have questions, please email: swdsriverlanding@hotmail.com