Enroll Now PPC - Centres for Early Learning

Parent / Guardian*

Child's Name*

Child's Date of Birth*

Home Phone Number*

Work Phone Number

Cell Phone Number

Email Address*

Requiring*

Location

Program:*

Infant (0-18 months)
Toddler (18 months - 30 months)
Preschool (2 1/2 years - 4 years)
Kinder (4 years - 6 years)
School Age

How many children do you have?

When are you looking for childcare?

Are you receiving, or have you applied for a subsidy?*

Will you be paying full fee?

How did you hear about us?

If other, please specify

Confirmation*

I confirm that the information entered above is correct

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