Prospective Family Application
Thank you for considering our schoolhouse for your chid’s early care and learnng. Please take a few moments to fill out this brief form so we can learn more about your family’s child care needs and goals.
Parents Name
Last Name
First Name
Middle Initial
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Home Phone
Please enter a valid phone number.
Format: (000) 000-0000.
Mobile Number
Please enter a valid phone number.
Format: (000) 000-0000.
Child's Name
Last Name
First Name
Middle Initial
Child's Age
Child's Date of Birth
Child's Gender
Are you interested in full time or part time enrollment?
Yes
No
If part time, what days and hours are most appealing to your family? (please indicate one of. the following
Monday-Wednesday-Friday
Tuesday-Thursday
If Monday-Wednesday-Friday
Full Day
Partial Day
If Tuesday-Thursday
Full Day
Partial Day
What specifically do you hope to gain by enrolling your child in 10 Fingers 10 Toes?
How is your child presently cared for during the day?
If you are transferring your child from a different early childhood program, please identify by name and location. Share succinctly your family's reason for seeking alternative child care?
Does your child socialize well with children in a group environment?
What special interests and talents does your child possess?
Are there special areas of focus you would like for your child.
What activity (or activities) brings the most joy to your child?
How did you learn about our program?
Please feel free to share any other information that will help us to fully nurture and care for your child.
Submit
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