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ECLC Waitlist
Please verify reCaptcha before submitting the form.
*
Parent 1: First Name
*
Parent 1: Last Name
*
Parent 1: Phone
*
Parent 1: Email
Parent 2: First Name
Parent 2: Last Name
Parent 2: Phone
Parent 2: Email
Child's Name
*
Child's Age & Birthdate
Desired Schedule
Half Day (9:00am-1:00pm)
Full Days (8:30am-4:30pm)
Extended Days (7:45am-6:00pm)
Please select the wait-list to which you would like to add your child.
Wait-lists are based on the schedule options. Choose the schedule you would like for your child.
Days/Week Schedule
3
4
5
Please select how many days per week you would like to send your child. .
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Desired Start Date
Please let us know when you would like your child to start at ECLC (please give the most accurate date possible).
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Wait List Deposit - $50
Wait List Deposit - $50
In order to hold your child's spot on the waitlist, please pay the waitlist deposit. This deposit will be credited toward your Materials Fee upon enrollment.
Total Deposit
Sat, April 20 2024 12 Nisan 5784