Family Connections Enrollment Form

Early Learning Classes

Nurturing Families

For caregivers and children from birth to age 3
Tuesday & Thursday
9am - 12pm

Preschool

For caregivers and children from ages 3 to 5
Monday, Wednesday, & Friday
9am - 1pm

Our Early Learning Summer classes will begin on June 20, 2023.

Young Scholars

For families with children in Kindergarten through Fifth Grade
Provides academic support & enrichment opportunities, including tutoring, to meet each child's unique learning needs
Monthly parent-participation activities and mental health workshops

Early Learning Classes (birth - age 5)Babies in Bloom Caregiver-Child Group (birth - 12 months)Young Scholars (Kindergarten - Fifth Grade)Workshops and Community EventsI'd like to learn more about what is available

2023 Summer Program2023 - 2024 School Year Program

Locations:

East Palo Alto - 2033 Pulgas Ave, East Palo Alto, CA 94303
East Palo Alto (Babies in Bloom ONLY) - 1070 Beech St, East Palo Alto, CA 94303

Redwood City - 414 4th Ave, Redwood City, CA 94063

East Palo AltoRedwood City

At this time, our Redwood City Summer Program is at capacity. We invite you to consider joining our East Palo Alto Summer Program, or we can add you to the waitlist for the Redwood City site.

We will do our best to assign families to their preferred site based on availability and the order in which all required documentation is received.

First NameMiddle NameLast Name

Nurturing Families (birth - 3 years old)Preschool (3 - 5 years old)Young Scholars (Kindergarten - Fifth Grade)

First NameMiddle NameLast Name

Nurturing Families (birth - 3 years old)Preschool (3 - 5 years old)Young Scholars (Kindergarten - Fifth Grade)

First NameMiddle NameLast Name

Nurturing Families (birth - 3 years old)Preschool (3 - 5 years old)Young Scholars (Kindergarten - Fifth Grade)

Please enter a valid phone number.

EmailTextPhone CallOther

MaleFemaleNonbinaryOther

YesNoChoose not to disclose

Please enter a valid phone number.

EmailTextPhone CallOther

MaleFemaleNonbinaryOther

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Please enter a valid phone number.

EmailTextPhone Call / VoicemailOther

MaleFemaleNonbinaryOther

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	How many are in your household?
Adults (including yourself)
Children birth-2
Children 3-5
Children 6-10
Children over 10

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Yes - Returning FamilyNo - New Family

Enrollment Form

Child #1 Information

Child #2 Information

Child #3 Information

Primary Caregiver

Caregiver #2

Caregiver #3

Household Information