Day By Day Child Development Center

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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