Admissions Interest Form
Parent or Guardian's Name
Child's Date Of Birth
Best number to reach you
Street Address Line 2
State / Province
Postal / Zip Code
How did you find out about us?
Wake County School System Preschool/ Office of Early Learning
Childrens' Developmental Services Agency (CDSA)
Childcare Subsidy Office/ Caseworker
Social Media (Facebook, Instagram, etc.)
Services Your Child Receives (or is waiting to receive)
Note any services(childcare, therapy, etc.) your child is currently receiving or any that you are planning to access.
What type of program are you interested in for your child?
Should be Empty: