Join our waiting list.

We are excited that you are interested in our program!

Please read the following before adding your information to the waiting list.

You are placing your name on a waiting list ONLY. Submitting this form does not constitute a guarantee of a space in our program.

All information submitted will remain confidential and will only be used to contact you about possible placement.
Please ensure the accuracy of all submitted information. Should your contact information change, please notify us immediately via email at esceulitadeohiocity@gmail.com.
Should you find alternate care and no longer wish to be on the waiting list, please notify us immediately via email at esceulitadeohiocity@gmail.com.
Priority on the waiting list is given to Escuelita de Ohio City parents who already have children enrolled, Escuelita de Ohio City employees, and families requesting full-time care.
Waiting list forms are honored in the order that they are received, based on requested entry date and availability.
Waiting list forms expire after one year from the date received. If this date has passed, you must fill out a new form.

We do not discriminate on the basis of race color, religion, national origin, sex, age, disability or sexual orientation.

Name of Person Completing This Form

First Name

Last Name

Parent or Guardian Name

First Name

Last Name

Parent or Guardian Name 2

First Name

Last Name

Child's Name

First Name

Last Name

Child's Age

Child's Birth Date or Due Date

Child's Sex

Male

Female

Unknown

Other

Care Needed

Full-Time Care

Part-Time Care (not available for infants)

Days of the Week Your Child Needs Care

Primary Hours of Care

Requested Start Date for Care

Additional Children

Please use this area to list any additional children you wish to enroll. Please include full name and date of birth.

Join our Family.