Application

Child's Gender

Male

Female

TBD

First Parent's Name *

First Name

Last Name

Home Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone *

(###)

###

####

Second Parent's Name

First Name

Last Name

Home Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

(###)

###

####

Is either parent a member of CUMC?

Yes

No

Is either parent currently a LB co-op member?

Current co-op members do not need to pay the $100 fee to add another child to the waitlist.

Yes

No

My child’s classroom assignment will be at the discretion of the Director. If my child is enrolled, I will perform a coop job (e.g., board member, Play-Doh prep, snack, etc. — approximately 5 hours per month), participate in the mandatory annual fundraiser, attend two parent-teacher conferences and the annual coop meeting to elect Board officers. I will be issued a Parent Handbook further detailing the rights and obligations of members of this cooperative organization. *

I agree

I do not agree

Completion of the Waiting List Application does not guarantee your child will be offered a placement at Little Beginnings. However, an application for a child must be on file in order for that child to get an offer. We accept applications throughout the year. Most of our openings occur between mid-June and Labor Day. Please fill out a separate application for each child you wish to enroll. Should LBCDC offer a space for your child/children and it is declined for any reason, an additional $25 processing fee be required to remain on the waiting list. Families are requested to keep all contact telephone numbers, emails and mailing addresses current to ensure LB's ability to contact families as to enrollment opportunities and other information. *

I agree

I do not agree