Ann Arbor YMCA Child Development Center
School Aged Child Care Interest Form
Today's Date
*
mm/dd/yyyy
Your Name
*
Last Name, First Name
Email Address
*
Phone Number
*
Phone
Child's Name
*
Last Name, First Name
Child's Date of Birth
*
mm/dd/yyyy
What school does your child attend?
*
Preferred Start Date
*
mm/dd/yyyy
What is most important to you in a school aged child care program?
*
If enrolled in the program, would you be interested in applying for a scholarship?
*
How did you hear about us?
*
*
Send me a copy of my responses
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