Application

TMC Early Learning Center

for pre-kindergarten-aged children (3-5 years old)

Date picker

Child's last name

Child's first name

Child's date of birth (3-5 yr old)

Month

Day

Year

Parent (caregiver) last name

Parent (caregiver) first name

Address

Phone

Second Parent or Caregiver contact information (optional)

Parent 2 (Caregiver) last name

Parent 2 (Caregiver) first name

Parent 2 (Caregiver) address

Parent 2 (Caregiver) email

Parent 2 (Caregiver) phone

Please share your current ELRC status

Will you need before/after care?

Before Care

After Care

Both

Not at this time

Best method of contact

How did you hear about us?

Tell us who referred you.

Enter the name and email of the person referring you.