Account Information

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Account Information

Please fill out a separate form for each child.

Email *

First and Last Name of the primary account person *

Choose an employer: *

Select the Pine Pals location you prefer:

Pine Pals Fort: Offers intergenerational learning and care for infants, toddlers, preschoolers, after school and summer care for school-aged children. Priority placement is given to GoldPine employees.

Pine Pals Nest: Our new location on Greenleaf Ave, offers care for infants and toddlers. Priority placement is given to Sanford/GSS employees.

Pine Pals Fort: Intergenerational care for ages 6 weeks - 12 years

Pine Pals Nest: Infant and Toddler care for ages 6 weeks - 35 months

No preference (will place you on BOTH wait lists)

Home address (Street, City, State, Zip code) *

Mailing address, if different from home address

Cell phone number *

Work phone number

How did you hear about us? *

Friend / Referral

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Social Media

PinePals.org

BemidjiChildCare.org

Referred by Sanford/GSS

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