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For your convenience, you may wish to contact us about our daycare availability using the enrollment form below.
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Parent / Guardian Details
Ms
Mrs
Mr
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Parent First Name: (*)
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Parent Last Name: (*)
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Home Address: (*)
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City: (*)
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Prov: (*)
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Postal Code: (*)
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Preferred Contact Number: (*)
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Alternate Contact Number:
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E-mail: (*)
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Child 1 Details
Given Name(s): (*)
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Last Name: (*)
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Date of Birth: mm/dd/yyyy (*)
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Child 2 Details
Given Name(s):
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Last Name:
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Date of Birth: mm/dd/yyyy
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Child 3 Details
Given Names(s):
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Last Name:
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Date of Birth: mm/dd/yyyy
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Daycare Requirements
Required Days:
Full Time/5 Days a Week
Monday
Tuesday
Wednesday
Thursday
Friday
Undecided
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Preferred Start Date: mm/dd/yyyy
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How Did You Find Us
Personal Referral
Kelowna Child Care Society
Internet Search
Castanet Ad
Yellow Pages
Direct Mail
Other
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If Other Please Describe
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General Comments:
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