Early Impressions Childcare Interest Form - Michigan Center
Hello!
Please fill out this form with as much detail as possible. The site director will contact you to chat more about your childcare needs and invite you in for a tour of our facility.
Thank you!
* Indicates required question
Email *
Parent Name *
Your answer
Parent Phone Number *
Your answer
Parent Email Address *
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Child(ren)'s Name and Date(s) of Birth *
Your answer
Please list the days of the week and the times needed for care each day for each child. *
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Does your child currently receive any special education services or medical related services? In an effort to best support your child in the classroom, this information helps our teachers be informed and ensure the environments suits the needs of every child. If your child has an IEP, a 504, or any documentation regarding a medical condition, we request you provide us with those documents.
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How did you hear about us? *
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Please share any questions you would like the director to answer when they reach out to you.
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