Child Information

Child's Name *

Gender *

Male
Female
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Current Age *

Child's Birth Date *

Current environment (home, school, center, relatives, etc.)

Address

City

State

Postal code

Home phone *

Language spoken at home

School year applying for / Desired start date

Program:

Please select desired program and schedule. All programs are 5 days a week. All Nido and kindergarten-aged children attend full-day. Children may be expected to follow a shortened phase-in schedule for their first week of school to make the transition into their new environment as smooth as possible.

Nido Infant Community (8 weeks – 16 months)

AM Care (7:30-8:30)

Full-Day (8:30-3:30)

PM Care

1 Hour (3:30-4:30)

To Close (3:30 – 5:30)

Toddler Community (16 - 33 months)

AM Care (7:30-8:30)

Half Day (8:30 – 11:30)

Full-Day (8:30-3:30)

PM Care

1 Hour (3:30-4:30)

To Close (3:30 – 5:30)

Children’s House (33 months - 6+ years)

AM Care (7:30-8:30)

Half Day (8:30 – 12:00)

Full-Day (8:30-3:30)

PM Care

1 Hour (3:30-4:30)

To Close (3:30 – 6:00)

Are you interested in receiving information regarding tuition assistance

Parent/Guardian #1:

First Name *

Last Name *

Home address (if different from student)

Phone # p1

Email *

Are you a legal guardian?

Yes

No

Are you financially responsible for the child?

Yes

No

Parent/Guardian #2:

First name

Last Name

Home address (if different from student)

Phone #

Email address

Are you a legal guardian?

Yes

No

Are you financially responsible for the child?

Yes

No

*E-mail is our main means of communication. You will only receive emails from Children’s Workshop. We will not share your email address.