Pense Daycare Centre Waitlist Application

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Priority for spots will go to Town of Pense and RM of Pense residents for initial opening

Parent/Guardian Name(s) *

Email *

Address *

Phone number *

Fundraising or Board Membership Interest *

Would you be willing to be a part of the Board or participate in fundraising for the centre?

Yes, I am interested in joining the Board

Yes, I am interested in helping with Fundraising projects

No, I am no interested in either roles at this time

Required

Care Required

Please provide your requested drop off / pick up times as well as what month/year you would anticipate needing daycare services to start

Child 1

Please provide child's Full Name, Date of Birth, and if they will be registered at Pense School

Child 2

Please provide child's Full Name, Date of Birth, and if they will be registered at Pense School

Child 3

Please provide child's Full Name, Date of Birth, and if they will be registered at Pense School

Child 4

Please provide child's Full Name, Date of Birth, and if they will be registered at Pense School

Extra or Comments

Please provide any unique needs or accommodations your child(ren) may require.
If more than 4 children please use this space to provide the information for the remaining family members requiring care.

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