Wait List Form

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First Step Learning Center's Wait List Form

* Indicates required question

Name of Child *

Your answer

Child's Date of Birth *

YYYY

Parent Contact *

Your answer

Parent Email *

Your answer

Home Telephone

Your answer

Work Telephone

Your answer

Mobile Phone

Your answer

Desired Start Date

YYYY

Program Desired *

Infant (6 weeks -2 years)

Toddler (2 years - 3 years)

Preschool (3 years - 5 years)

Schedule Desired *

Full Time (Monday - Friday)

3 Days (Monday / Wednesday / Friday)

2 Days (Tues / Thurs)

Confirmation

You will receive a confirmation once you have submitted this form. If space is available we will require a $50 deposit.

Submit

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