Day By Day Child Development Center - "Building Bright Futures since 1996"
Request More Information
*= REQUIRED
* Child's First Name
* Child's Date of Birth
2nd Child's First Name
2nd Child's Date of Birth
* Program needs by age group:   Infant care - 6 weeks to 16 months
  Toddler care - 16 months to 31 months
  Preschool for 3's - 31 months to 44 months
  Prekindergarten - 44 months to Kindergarten
* When is care needed?
* Days of care needed:   Monday
  Tuesday
  Wednesday
  Thursday
  Friday
* Type of care needed:   Full-time days
  2/3's days (between 5 and 7 hrs/day) start anytime
  FT and 2/3's days (comment below)
  Drop-in care - Full day
  Drop-in care - 2/3's day
  Summer only
* Specific needs or requirements? Select all that apply.   None
  Food allergies (comment below)
  Special needs child (comment below)
  Receive county assistance (comment below)
  Other (comment below)
* How did you hear about our program? Check all that apply.   Referral (comment below by whom)
  Drove by
  Website
  Web search (comment below which one)
  Advertisement
  Yellow pages
* Parent First Name
Parent Last Name
* Your relationship to child/ren:
* Parent Phone Number: - -
* Parent E-mail Address:
* Best Time to Contact You   Mornings - 8am to 11am
  Mid-day - 11am to 1pm
  Afternoons - 1pm to 5pm
  Evenings - 5pm to 7pm
* Best Way to Contact You:   E-mail
  Phone call
  Either
Questions and/or Comments:
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