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If you would like to apply for Basics of Life Christian Child Care or Preschool,
You can call us and then fax it to (740) 694-1622 or mail it to:
Basics of Life Christian Child Care
APPLICATION FOR ADMISSION
Basics of Life Christian Child Care is a Christian based child care and pre-school for children of all ages who seek opportunities to learn and grow.
Please provide the following contact information:
Parent Name(s) _______________________________________________________
City __________________________________State __________ Zip ____________
Email address _______________________________________________________
Telephone numbers (include area code) where you can be reached:
In case of an emergency, and you can not be reached, please provide an additional contact
name and phone number _____________________________________________________
What type of care are you interested in?
Full Time Part time Preschool only
What days of the week do you require care?
Monday Tuesday Wednesday Thursday Friday
What times do you require care? Drop off time: _______________ AM / PM
What date would you like to start? ____________________________________
Please provide the following information about the child requiring care:
First and Last Name: _________________________________
Gender Male Female
Birth Date ______________________
Does your child have allergies or other special needs we need to be aware of?
Is your child potty trained? Yes No
Do you have any other concerns you feel need to be addressed? ____________________________________________
How did you hear about Basic of Life Christian Child Care? ___________________________________
Basics of Life Christian Child Care admits children without regard to race, color, national origin, ancestry,
PLEASE SEND COMPLETED APPLICATION TO: Basics of Life Christian Child Care
The information collected on this form will only be used to promote your child enrollment and care with Basics of Life Christian Child Care.
Copyright 2004 Basics of Life Christian Child Care. All rights reserved.