Little Rascals - New Enrollment Inquiry Form
Enrollment Inquiry Form for new customers
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Email *
Parent's Name
Parent's Phone #
When do you plan to enroll *
Need full time or part time Care *
Required
Previously Enrolled in a daycare? If yes please provide information. Special needs ? Please specify
Student 1: Name & Date of Birth - Add School name if Pickup and Drop is needed
Student 2: Name & Date of Birth Add School name if Pickup and Drop is needed
Student 3: Name & Date of Birth Add School name if Pickup and Drop is needed
How did you hear about
Do you have NCI, if not would you like to know more about it. This is Texas a Workforce Childcare Assistance program. You can see details here or in your email after the form is submitted https://tinyurl.com/r3lsrme
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Comments, Questions, Remarks
A copy of your responses will be emailed to the address you provided.
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