2018-2019 Extended Learning Center Registration
The NC Division of Child Development requires a separate application for each child. Complete fee information is available on the webpage.
Please read and check this box to continue *
Required
Please Select School *
Child's First Name *
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Child's Last Name *
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Child Goes By
Name child goes by:
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Student ID Number
Same as cafeteria number
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Child's Date of Birth *
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First Day the Child will Attend the Program *
MM
/
DD
/
YYYY
Child's Current Teacher *
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Child's Current Grade Level *
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