Enrollment — Perry Preschool & Child Care

Enrollment - Wait List Form

When applying for a position at Perry Preschool & Child Care, your child’s name will be placed on a waiting list for a non-refundable fee of $40.00. Once we have a space available, we will contact you and give you the option of taking the space or remaining on our waiting list.

Positions are offered throughout the year as they become available.

Important Information

Applications must be completed in full
There is a non-refundable $40.00 fee which must accompany the application form
Families with CCDF (Child Care and Development Fund) vouchers are not required to pay this fee
A fact sheet form is available here, for families to read, prior to completing the wait list form. The fact sheet outlines the waiting list procedure.

Child Care Development Fund (CCDF) Program

The Child Care and Development Fund (CCDF) helps low-income families obtain child care so they can work, attend training or continue their education. The purpose of CCDF is to provide low-income families with the financial resources to locate and afford quality child care as well as increase the availability of these programs.

Learn more

Wait List Form

Child Information

First Name

Last Name

Date of Birth

MM

DD

YYYY

Gender

Female

Male

Prefer to not disclose

Requested Approximate Start Date

MM

DD

YYYY

Days and Times of requested care:

Full Time Care Drop-In Care Before School and/or After School Care

Please describe what days and hours your child will need care.

Please note Preschool hours are 8:00 am - 12:00 pm Monday - Friday, with wrap-around child care included.

Parent/Guardian Information

First Name

Last Name

Relation to child

Contact Phone No.

(###)

###

####

Home Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Email

Employer

Employer Phone No.

(###)

###

####

Additional information

Main language spoken at home?

Additional needs of the child?

Medical conditions of the child?

Disability or developmental delays of the child?

Please provide us with any other additional information we should know about your child:

Other children in the family

Please list any additional children in the family, starting with their full name, sex, date of birth, and if they are in need of childcare (if applicable).

Parent/Guardian Signature

By typing your name, date, and choosing "I Accept", you are signing this form electronically.

First Name

Last Name

Date

MM

DD

YYYY

I certify that the information submitted in this application is true and correct to the best of my knowledge.

I further understand that any false statements may result in denial or revocation of my child from Perry Preschool & Child Care.

I Accept