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Pre Enrollment
Thank you for your interest in The Childhood Experience: Learning Facility! Please fill out this form for pre enrollment and you will receive a call back within 2-4 business days.
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* Indicates required question
Email
*
Your email
Parent Name
*
Your answer
Child/Children Name
*
Your answer
Child #1 Age
*
Infant 6 weeks- 1yr
Toddler 1yr- 2 yr
Preschool 2yr- 4yr
Required
Child #2 Age
*
Infant 6 weeks- 1yr
Toddler 1yr- 2 yr
Preschool 2yr- 4yr
N/A
Required
Days and Hours
*
Full time
Part time
Overnight
Early Morning (Before 7am)
Late Afternoon (After closing
NONE
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Full time
Part time
Overnight
Early Morning (Before 7am)
Late Afternoon (After closing
NONE
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Phone Number
*
Your answer
Questions!
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