Get Started

Thank you for your interest in the Felician Children’s Center. We offer Infant, Toddler, Preschool, and Kindergarten Readiness programs for children 2 weeks to 6 years of age. The first step is to complete the following information inquiry and a member of our team will connect with you about the next steps!

Child Care Inquiry

Child's Information

Full Name

First, Middle Initial, Last

First Name

Last Name

Child's Nickname

First Name

Last Name

Date of Birth

MM

DD

YYYY

Age

Primary Residence

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Parent/Guardian Responsible for Payment of Services

First Name

Last Name

Parent/Guardian #1

Name

First Name

Last Name

Relationship to Child

Cell Phone

(###)

###

####

Home Phone

(###)

###

####

Work Phone

(###)

###

####

Email

Home Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Parent/Guardian #2

Name

First Name

Last Name

Relationship to Child

Cell Phone

(###)

###

####

Home Phone

(###)

###

####

Work Phone

(###)

###

####

Email

Home Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Child Care Needs

Days Your Child Will Attend

Select all that apply

Monday

Tuesday

Wednesday

Thursday

Friday

Expected Start Date

mm/dd/yyyy

Approximate time your child will be in attendance each day:

Until your child is able to eat table food, parents agree to the following:

• Provide formula, milk, and/or baby food for your child each day • All formula must be prepared at home and placed in sanitized "ready to feed" bottles with nipples and covers • Each day all bottles and baby food jars must be labeled with the child's name and the date • All unfinished items will be sent home daily

I Agree

I Need to Discuss Further

Does your child have food allergies?

If yes, you agree to provide adequate, nutritious substitutes for your child each day. (A monthly menu will be provided the first of each month.)

Yes

No