20-21 All Day Child Care Enrollment
Lakeview School District School Age Child Care Application for Enrollment for the 2020-2021 first trimester.  Please note, a Child Care application needs to be completed for each student you wish to receive child care services. All Day child care is available from 8:30am - 3:30pm
Sign in to Google to save your progress. Learn more
Email *
Students First Name *
Students Last Name *
Students Date of Birth *
MM
/
DD
/
YYYY
Home Address (House #, Street, City) *
State & Zip Code *
Home phone number *
Elementary Building Student will attend during the 2020-2021 school year *
Parent/Guardian Name (mom) *
Parent/Guardian (mom) cell phone number *
Parent/Guardian (mom) Email address *
Parent/Guardian Name (dad) *
Parent/Guardian (dad) cell phone number *
Parent/Guardian (dad) Email address *
Name and Grade of Siblings currently enrolled in Child Care program *
Which Child Care Days are you applying for? *
Child Care tuition schedule:  Daily fee: $20.00 or Weekly fee: $80.00.  Payments must be made the week prior to service. Your first weeks tuition will reserve your students placement in the program, and is due one week prior to attendance. Please remit payment to: Lakeview Child Care 15 Arbor Street Battle Creek Mi 49015.
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Lakeview School District. Report Abuse