CSEC Childcare Enrollment Form
Creating Success Education Center is a 5-Star Licensed Childcare Center serving students ages 2-5 and school-age students through age 12. The center is open 7:00 a.m. - 5:30 p.m.

Call 252-621-5190 to receive your monthly rate. Tuition is based on student age at enrollment.

Vouchers are accepted.

Please fill out a separate registration form for each student you have.

Contact chenderson@turningpointcdc.org or 252-621-5190 with questions.
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Student Name *
Student Date of Birth *
MM
/
DD
/
YYYY
Street Address *
Mailing Address
City
State
Zip Code
Parent/Guardian Name *
Phone Number 1 (Please make sure this is a cell phone number)
 *
Parent/Guardian Email
 *
Parent/Guardian Name
Phone Number 2
Parent/Guardian Email 2
Do we have permission to send text message updates? (Must be a mobile device)
 *
Which program are you enrolling? *
 *
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