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St. Francis Day Care Center
An apostolate of the Sisters of St. Francis of the Martyr St. George
"Let the children come to Me, for theirs is the Kingdom of Heaven." Luke 18:16
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Application for Admission
Application for Admission
You must have JavaScript enabled to use this form.
Note: Please fill out a separate form for each child you are seeking to enroll at Saint Francis Day Care Center.
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Date Needing Care:
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Family Name:
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Mother:
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Father:
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Address:
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City:
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State:
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Zip Code:
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Phone Number:
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Marital Status:
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Name of Child for whom placement is requested (Last, First, Middle):
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Date of Birth:
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Place of Birth Hospital Name:
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Sex:
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Days of Week the child will attend:
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Hours of Day child will attend:
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Mother's Employer:
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Hours:
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Mother's Employer phone number:
Mother's Employer address:
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Father's Employer:
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Hours Worked:
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Father's Employer phone number:
Father's Employer address:
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Has the child had previous Day Care placement?:
If yes, Name and Address of previous Center(s):
Other Members of Household including children not in Day Care, in age order:
Additional Comments:
How did you find out about us?
Email Address:
*
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