Our center is licensed to care for children between the ages of six weeks and twelve years old. We do not discriminate against children on the basis of race, color, gender, or national origin. Please provide the following information about your child.

Gender

Parent/Guardian Information

Does this child live at more than one address weekly? (For example: Shared Custody) *

Parent/Guardian #1

Parent/Guardian #2

About Your Child

Is your child potty trained? (for 2 years and older) *
Does your child have siblings who attend one of our Centers currently or in the past? *
Has your child been enrolled in a daycare before? *
Has your child received services through the Birth to Three Program?
If yes, please check the services your child has received.
Has your child received services from a mental health professional?
Does your family qualify for assistance with tuition through Connect or Link Resources and Referral? *

If unsure, please contact Link (Putnam County) at 304 523-9540.

Has your child been enrolled in a daycare before? *
Does your child require an EpiPen?