Evergreen Learning Center Application

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Thank you for you interest in Evergreen Learning Center. Please note: we are currently full for the 2023-2024 school year. Your application will be considered for fall 2024. A non-refundable $50.00 application fee is required to place your child on our wait list. Paid wait list fee does not guarantee your child's admission. Please return to admissions at www.elcingoleta.com/admissions for more information.

Email *

1. Parent/Guardian

Relationship to Child

Contact Number

2. Parent/Guardian

Relationship to Child

Contact Number

Preferred Start Date

YYYY

I have flexibility in start date

Yes

Some flexibity

Clear selection

Child's Name

Child's Birth Date

YYYY

Child's Gender

Female

Male

Prefer not to say

Clear selection

I would like to add additional child/ren

Yes

Clear selection

Clear form

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