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NOW HIRING EARLY CHILDHOOD EDUCATORS!

ENROLLMENT APPLICATION

Welcome! Please read our Policies and complete this child care application as honestly and completely as possible. This application does not automatically enroll your child, but helps determine if this child care facility is a good fit for your child and family.

Sex
Date of Birth
Month
Day
Year

FAMILY INFORMATION

DESIRED WEEKLY SCHEDULE

Will your days of the week vary?

Monday

Drop-Off Time
Time
:
Pick-Up Time
Time
:

Tuesday

Drop-Off Time
Time
:
Pick-Up Time
Time
:

Wednesday

Drop-Off Time
Time
:
Pick-Up Time
Time
:

Thursday

Drop-Off Time
Time
:
Pick-Up Time
Time
:

Friday

Drop-Off Time
Time
:
Pick-Up Time
Time
:
daycare classroom

DAYCARE ENROLLMENT

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