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2019/2020 SPACE Childcare Interest Form
Complete one form per family
Email address *
Please fill out this interest form to be put on the waiting list. We will contact you if a spot opens up.
What is the best way to contact you *
Childcare is for Fairfield-Suisun Adult School Students. It is provided at an extremely low cost to our students only while they are in class at the Adult School
What programs do you intend to enroll in 2019/2020 school year. Check all that apply *
What time of day/night will you be attending classes? (Childcare is not available on Saturdays) Check all that apply. *
Parent's Name *
Your answer
Mailing address *
Your answer
Phone number *
Your answer
How many children do you intend to have in childcare *
What are your children's ages? Check all that apply. *
If there are any questions or comments you would like to include, please do that here. Thank you!!
Your answer
Please feel free to contact Cheryl Stumbaugh at if you have any questions.
A copy of your responses will be emailed to the address you provided.
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