You can fill out our online enrollment form
You may also fill out the paper copy below.
(Scroll to bottom of page for link to view if not viewable)
Please mail completed form to:
Parents as Teachers
100 N. Sappington
Kirkwood, MO 63122
fax to 314-213-6138
scan/email to firstname.lastname@example.org
Call the office at 314.213.6137 to enroll over the phone.
As a part of the program, this health form needs to be reviewed/completed once per program year, for each child enrolled. If you are a new family (even if on the waiting list), please fill out for your child and e-mail to:
Feel free to e-mail or call the office 314.213.6137 with questions!
If you are family that already is involved in our program and have yet to fill this out for your child(ren), please complete and return to your Parent Educator.