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Grace Little People

Download The Enrollment Application


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33801 Van Dyke Avenue
Sterling Hgts, MI 48312
(14 Mile and Van Dyke)

Child's Name: *
Enrollment Application
Name Child goes by:
Birthday: *
Street: *
City: *
Zipcode: *
Phone Number: *
Program Desired: *
Infant/Toddler
Preschool 2/3
Preschool 4/5
Plan Desired: *
Half Day:
Arriving at:
Departing at:
8:30am - 3:30pm
6:30am - 6:00pm
Days Desired: *
Monday
Tuesday
Wednesday
Thursday
Friday
Additional Information:
Does your child have any allergies? *
Does your child have any emotional problems that the Daycare should be aware of? *
Does your child have any physical problems that the Daycare should be aware of? (Asthma, tubes in ears, etc.) *
Is your child taking medication on a regular basis? *
Yes
No
If yes, what medication?
Has your child previously been in a daycare setting? *
Yes
No
If yes, what daycare center?
Names and ages of siblings:
Who does the child primarily reside with?
Is child adopted?
Yes
No
If yes, does the child know?
Status (select one) *
Single
Married
Divorced/Separated
Widowed
If divorced, who has legal custody?
Mother
Father
Both
Please fill out the enrollment application below to register your child. Note that fields with an asterisk (*) are required.

Little People Day Care Center © 2011.
A Ministry of Grace Christian Church. All Rights Reserved.