ILCS Infant & Toddler Program Waitlist Request Form: 2024-2025 School Year
Thank you for your interest in Immanuel Lutheran's Infant & Toddler Program for the 2024-2025 school year! Please complete the following form for each individual child. By completing this form you are requesting to place your child on the waitlist for the 2024-2025 school year. At the end of the 2024-2025 school year families have the opportunity to request to continue on the waitlist if spot is not available. Families will be contacted by the Director when a child moves into the top spots of the waitlist. Additional questions: please email the Infant & Toddler Program Director, Tabitha Holtmeyer, tabitha.holtmeyer@imlutheran.org
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Parent Contact Information:
1. Parent Full Name
2. Parent Email
3. Parent Phone Number *
Child's Full Name
Child's birthday/due date
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DD
/
YYYY
Requested start date of care
MM
/
DD
/
YYYY
Room Selection-
Clear selection
Number of Days Requesting
Days Requesting
Current active church membership at Immanuel Lutheran Church *
Interest in church membership at Immanuel Lutheran Church? *
If interested in possible church membership, would you like your contact information to be shared with the Immanuel Lutheran Church Pastors? *
Name of other active church membership:
Additional children enrolled at Immanuel Lutheran School
Clear selection
If Yes; please list the name and grade of additional siblings enrolled at ILS
How did you hear about Immanuel Lutheran's Infant and Toddler Program?
Additional questions/comments:
I understand that I am requesting to place my child on the waitlist for the 2024-2025 school year. At the end of the 2024-2025 school year, I am aware I will need to request to continue on the waitilist if a spot is not available.  *
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