Child's Information How many children would you like to apply? Child's Name *
First
Last
Gender * Is child a Dual Language Learner? *
Child's Name *
First
Last
Gender * Is child a Dual Language Learner? *
Child's Name *
First
Last
Gender * Is child a Dual Language Learner? *
Child's Name *
First
Last
Gender * Is child a Dual Language Learner? *
Parent/Care Giver's Information Name *
First
Last
Address * Employed * Is there another parent/care giver? * Name *
First
Last
Address * Employed * Based on the age of your child and your annual income, your weekly fee will be $130.00.
Based on the age of your child and your annual income, your weekly fee will be $140.00.
Based on the age of your child and your annual income, your weekly fee will be $151.00
Based on the age of your child and your annual income, your weekly fee will be $166.00
Based on the age of your child and your annual income, your weekly fee will be $182.00
Based on the age of your child and your annual income, your weekly fee will be $198.00
Based on the age of your child and your annual income, your weekly fee will be $213.00
Based on the age of your child and your annual income, your weekly fee will be $229.00
Based on the age of your child and your annual income, your weekly fee will be $244.00
Based on the age of your child and your annual income, your weekly fee will be $265.00
Based on the age of your child and your annual income, your weekly fee will be $97.00
Based on the age of your child and your annual income, your weekly fee will be $103.00
Based on the age of your child and your annual income, your weekly fee will be $108.00
Based on the age of your child and your annual income, your weekly fee will be $113.00
Based on the age of your child and your annual income, your weekly fee will be $120.00
Based on the age of your child and your annual income, your weekly fee will be $125.00
Based on the age of your child and your annual income, your weekly fee will be $136.00
Based on the age of your child and your annual income, your weekly fee will be $154.00
Based on the age of your child and your annual income, your weekly fee will be $166.00
Based on the age of your child and your annual income, your weekly fee will be $182.00
Based on the age of your child and your annual income, your weekly fee will be $203.00
Based on the age of your child and your annual income, your weekly fee will be $88.00
Based on the age of your child and your annual income, your weekly fee will be $94.00
Based on the age of your child and your annual income, your weekly fee will be $100.00
Based on the age of your child and your annual income, your weekly fee will be $106.00
Based on the age of your child and your annual income, your weekly fee will be $112.00
Based on the age of your child and your annual income, your weekly fee will be $117.00
Based on the age of your child and your annual income, your weekly fee will be $129.00
Based on the age of your child and your annual income, your weekly fee will be $147.00
Based on the age of your child and your annual income, your weekly fee will be $156.00
Based on the age of your child and your annual income, your weekly fee will be $172.00
Based on the age of your child and your annual income, your weekly fee will be $192.00
Please select all that apply: (leave blank if none apply) Waitlist Fee Policy * A one-time, non-refundable $25 waitlist fee is required for each child care waitlist application. This fee is required to submit your child’s application and secure a place on the waitlist.
Please note: If your child rolls off the waitlist and is no longer active on the waitlist, you will need to submit a new application and pay a new $25 waitlist fee if you wish to be placed on the waitlist again.
The waitlist fee is non-refundable and does not guarantee enrollment or placement in a classroom.
Signature *