Pre-Enrollment Waitlist Form – Carpinteria Children's Project

Child information

Last name

First name

Date of birth

Request date (if available)

Parent information

Last name

First name

Phone

Email

Home address

Address Line 1

Address Line 2

City

State

Zip Code

Are you interested in applying for a scholarship?

Yes
No

Flexible schedule?

Yes
No

scholarship? of name

Comments

Preferred Schedule

Part Time (8:00am – 12:00pm)
Extended Schedule (7:30am – 2:30pm)
Full time (7:30am – 5:00pm)

Days

Type of care

Toddler Care (18 months – 2 years)
Young pre-school (3 years – 4 years)
Pre-school (4 years – 5 years)

*A $125 registration fee will be required upon confirmation of enrollment*

The information you provide will allow us to contact you about special events, health screenings, and classes for families and children of an age similar to yours that will help you prepare your child for kindergarten.

Email

Stay in the know

Child information

Parent information