Enrollment Inquiry
Enrollment and our waitlist for Creative Steps are currently full. However, please provide us your information so that we may contact you when space becomes available.
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Email *
Name of individual who would be receiving supports *
If you are filling this form out on behalf of the individual looking to enroll, please indicate your full name and relationship. *
Phone Number *
What is the best way to contact you? *
Date of Birth for person enrolling *
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Please indicate your current Regional Center. *
* We are currently only vendored with WRC, TCRC and NLACRC
Please indicate which program location you are inquiring about

Santa Monica (includes West LA area)
North LA  (includes Calabasas, Agoura, Thousand Oaks, Westlake Village, Ventura, Simi Valley)
South Bay  (includes Torrance, Redondo Beach)
 *
Required
Please provide the name of your current service coordinator.  *
If you don't know please write "unknown"
Are you currently enrolled in another day program?
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Please indicate the city of residence for the individual *
Thank you! 
Thank you for your interest in Creative Steps. Enrollment and our waitlist for Creative Steps are currently full. However, please provide us your information so that we may contact you when space becomes available. You will be contacted in based on program location and the order in which your inquiry is received. 
A copy of your responses will be emailed to the address you provided.
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