Reservation Form: Hornet Family Study Care Sessions Two & Three
Event Dates: May 6th-15th, 2019
Event Address: Children's Center @ Sacramento State
Event Information: Free childcare for pell-eligible students to study on campus. Child must be between the ages of six months and kindergarten. This service is available through the CCAMPIS grant through the US Dept. of Education in order to support student-parents.

*Signing up does not guarantee you a spot.
**Please fill out separate registration form for each child.
Sign in to Google to save your progress. Learn more
Your Name *
Student ID Number *
Email-Primary Contact *
Phone Number *
Are you Pell-Grant Eligible? *
Child's Name (first name and last name) *
Child's Date of Birth *
MM
/
DD
/
YYYY
Child's Age Category *
Does your child have any special care needs? *
If your child has special care needs, what are they?
Is your child currently enrolled at the Children's Center for daycare? *
Please check all days that your child will be attending.
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy
Google Forms