Guilderland Application


Please fill complete and submit the form below to be added to our registration wait list. 

Parent/Guardian INFORMATION
Parent/Guardian *
Parent/Guardian
Address *
Address
Cell
Cell
Work
Work
Home
Home
STUDENT INFORMATION
Child's Name
Child's Name
Date of Birth
Date of Birth
Child's Name
Child's Name
Second child, if applicable
Date of Birth
Date of Birth
Child's Name
Child's Name
Third child, if applicable
Date of Birth
Date of Birth
When would you like enrollment to begin?
When would you like enrollment to begin?
Select the building that you would prefer.
SIGNATURE and SUBMISSION
This form only expresses your interest in our program. It is simply an application to have your child(ren) considered for placement. This application does not obligate you or Club Fed Child Care Center, op by Victory Child Care, Inc. for acceptance to or of the program. I understand the conditions set forth by this application.