Hoffman Early Learning Center Interest Form
Thank you for your interest in the Hoffman Early Learning Center. Please complete the following information and we will follow up with more information and next steps.
Child's First Name *
Your answer
Child's Last Name *
Your answer
Gender (if known) *
Date of birth *
For expecting mothers, list due date.
MM
/
DD
/
YYYY
Desired start date *
MM
/
DD
/
YYYY
Parent / Guardian #1 Name *
Your answer
Parent / Guardian #2 Name
Your answer
Address *
Your answer
Phone Number *
(xxx-xxx-xxxx)
Your answer
Alternate Phone Number
Your answer
Email Address *
Your answer
Please select which group you are interested in enrolling in: *
Do you work for one of our partner charter schools? If so, please list. *
Your answer
Do you believe you will qualify for Head Start assistance? *
If you are interested in scheduling a tour, please select your desired date & time below.
Do you have specific questions about the program?
Your answer
How did you hear about the Hoffman Early Learning Center? *
Required
Do you have another child you would like to add to the interest list? *
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