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UCLC Waiting List Application

Submission of the UCLC application, along with payment of the $50 non-refundable fee, will place your child(ren) on the UCLC Waiting List.

Please enter your child's information. If you are wanting to place multiple children on the waiting list, please provide information for each child.

Please enter required information and select "Add to Cart".

Fields with asterisk are required.

Child's Name (First & Last Name) *
Child's Date of Birth *
Days Requested *
Month Enrollment is Requested *
Year Enrollment is Requested *
Are you registering another child? *
Second Child's Name (First & Last) *
Child's Date of Birth *
Days Requested *
Month Enrollment is Requested *
Year Enrollment is Requested *
Are you registering another child? *
Third Child's Name (First & Last Name) *
Child's Date of Birth *
Days Requested *
Month Enrollment is Requested *
Year Enrollment is Requested *
Are you registering another child? *
Fourth Child's Name (First & Last Name) *
Child's Date of Birth *
Days Requested *
Month Enrollment is Requested *
Year Enrollment is Requested *
Parent/Guardian #1 Last Name *
Parent/Guardian #1 First Name *
Parent/Guardian #1 Status *
Relationship to Child(ren) *
Parent/Guardian #1 Email Address *
Parent/Guardian #1 Phone Number *
xxx-xxx-xxxx
Parent/Guardian #2 First and Last Name
Parent/Guardian #2 Relationship to Child
Parent/Guardian #2 Status
Parent/Guardian #2 Email Address
Parent/Guardian #2 Phone Number (xxx.xxx.xxxx)

$50.00

Qty:

Picture of UCLC Waiting List Application