The Children's Learning Center
Enrollment Application

Children's Learning CenterThe Children's Learning Center
Enrollment Application

You must submit a separate application for each child you wish to enroll. All questions with a red asterisk are required.

ENROLLMENT INFORMATION
Child's Name Child's Name * First Last
Parents' names and status (student?)
Child's Date of Birth Child's Date of Birth * / MM / DD YYYY
Child's Gender *

Child's Gender Male Female
ATTENDANCE SCHEDULE
I would like to enroll my child for the following Semester: *

I would like to enroll my child for the following Semester: Spring Summer Fall
Enrollment Year
Preferred Days & Times of Child's Attendance *

For Example:
Mon & Wed from 8:30-1:00
PARENT OR GUARDIAN INFORMATION
I am a current Hunter *

I am a current Hunter Student Faculty Member Staff Member
Parent or Guardian Name Parent or Guardian Name * First Last
Parent or Guardian Email Address *
Last Four Digits of Parent or Guardian's Social Security Number *
I am enrolled in the following Hunter program:
(students only)
My Anticipated Semester and Year of Graduation
(students only)
I am a *

I am a Full-time Student Part-time Student Faculty or Staff Member
Typical Schedule *

Typical Schedule Day Evening
Enrollment
(students only)

Enrollment
(students only) Undergraduate Graduate Postgraduate Continuing Education
Financial
(students only)

Financial
(students only) I receive PELL I have College Work Study
HOUSEHOLD INFORMATION
Name of Spouse/Partner of Parent or Guardian Name of Spouse/Partner of Parent or Guardian First Last
Is Spouse/Partner a Hunter Student?
(students only)

Is Spouse/Partner a Hunter Student?
(students only) Yes No
Home Address Home Address *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Home Phone Number Home Phone Number * - ### - ### ####
Mobile Phone Number Mobile Phone Number - ### - ### ####
YOUR CHILD'S SIBLINGS
Name: Name: First Last
Date of Birth Date of Birth / MM / DD YYYY
Name: Name: First Last
Date of Birth Date of Birth / MM / DD YYYY
Name: Name: First Last
Date of Birth Date of Birth / MM / DD YYYY
EMERGENCY CONTACTS
Authorized Escort (other person authorized to pick up my child) Authorized Escort (other person authorized to pick up my child) First Last
Authorized Escort's Phone Number Authorized Escort's Phone Number - ### - ### ####
Emergency Contact Person: Emergency Contact Person: * First Last
Emergency Contact Phone Number Emergency Contact Phone Number * - ### - ### ####
YOUR SIGNATURE
BY TYPING MY NAME BELOW, I CERTIFY THAT THE INFORMATION ON THIS APPLICATION IS CORRECT TO THE BEST OF MY KNOWLEDGE.
Today's Date Today's Date / MM / DD YYYY

The Children's Learning CenterEnrollment Application

Children's Learning CenterThe Children's Learning CenterEnrollment Application

ENROLLMENT INFORMATION

ATTENDANCE SCHEDULE

PARENT OR GUARDIAN INFORMATION

HOUSEHOLD INFORMATION

YOUR CHILD'S SIBLINGS

EMERGENCY CONTACTS

YOUR SIGNATURE

The Children's Learning Center
Enrollment Application

Children's Learning CenterThe Children's Learning Center
Enrollment Application