Eastminster Child Development Center
Child Care Application

Date _______

Child’s Full Name___________________________ Girl or Boy
Birth Date _____/_____/________
Parent(s) Name(s)____________________________________
Home Address_______________________________________
Home Phone ________________ Work Phone______________
Cell Phone __________________ Email ___________________

How did you hear about us?_____________________________

PREFERRED STARTING DATE _______________________

Age Group Schedule (circle part-time schedule or check full-time)

Toddler (ages 12-30 months)    Part-time M T W Th F am       or     ___ Full Time
                                                                 M T W Th F pm                       M-F

Preschool I (ages 2 ½ - 4)         Part-time M T W Th F am       or     ___ Full Time
                                                                 M T W Th F pm                       M-F

Preschool II (ages 4-5)              Part-time M T W Th F am       or     ___ Full Time
                                                                  M T W Th F pm                       M-F

Before/After School                    Part-time M T W Th F am       
(kindergarten)                                           M T W Th F pm   

Tuition

Other Fees

Tuition and other Fees are subject to change
- Updated December 2007

GENERAL INFORMATION

• HOURS: 7:00am – 6:00pm Monday through Friday
• Minimum schedule is two full days or three half days per week
• Breakfast, and snack are included in tuition costs; along with milk for lunch
• A box lunch needs to be brought in from home
• WE ARE A PEANUT FREE SCHOOL!
• Adult-child ratios are: Toddlers: 1:3.5, Preschoolers: 1:7.5 (Preschool I) and 1:8.5 (Preschool II)
• Tuition is paid monthly, in advance
• For admission into the Toddler Program the child must be at least 12 months old, must walk without assistance, must be able to understand simple directions, and feed him/herself finger foods.
• In accordance with Federal law and USDA policy, this institution is prohibited from discrimination on the basis of race, color, national origin, sex, age, or disability. To file a complaint of discrimination, write USDA, Director, Office of Civil Rights, Room 326-W, Whitten Building, 1400 Independence Avenue, SW, Washington, D.C. 20250-9410 or call (202) 720-5964 (voice and TDD). USDA is an equal opportunity provider and employer.
• We require a 2-week written notice to drop days from your child’s schedule or to disenroll
• For children who are picked up late, there will be late fees assessed and possible disenrollment if the lateness occurs frequently

Please include a $40 application fee with this application

Click here for Printable Version of Application