Waitlist- Christine Sinclair

Title *

Today's Date: *

Child's First Name: *

If name is unknown, please enter "baby" as first name and parents surname.

Child's Last Name: *

If name is unknown, please enter "baby" as first name and parents surname.

Child's Year of Birth: *

Note that all children must be at least 36 months of age by February 1, 2024 to be included in the initial opening seat lottery.

Child's Month of Birth: *

Parent/Caregiver One Full Name: *

Parent/Caregiver Two Full Name:

Email: *

Phone: *

Home Address:

Preferred date to start service: *

Please enter the approximate date you are looking to start child care. If you are entering in the waitlist for opening seats, your preferred start date must be February 1, 2024.

If your desired start date has passed when a spot becomes available, would you like to remain on the list? *

Please indicate if you are one of the following: *

If City of Burnaby employee, please indicate location.

Is there any additional information you would like us know?

Are you looking for full or part time care? *

Full Time (Monday - Friday)

Part Time Only (3 days)

Part Time Only (2 days)

Please note priority will be given to full time enrollment.

ADMIN ONLY (Exit Waitlist?): *

ADMIN ONLY (Reason for exit):

ADMIN ONLY: Exit Date

ADMIN ONLY (notes):

Attachments:

Add Attachment

Waitlist- Christine Sinclair - New Item