CENTERS & FACILITIES

REQUEST FOR ENROLLMENT
Early Childhood Education Centers
 ELIGIBILITY - CHILDREN MUST BE 3 YEARS OF AGE AND POTTY TRAINED

* Indicates manditory fields, if they don't apply enter N/A

Center Type*:

Learning Center - All Day - Monday Through Friday
Flex-Time Center - Part-Time Child Care
Full Name of Child*:
 
Age of Child*: Birth Date*: (mm/dd/yy)
 
Parent/Guardian's Name*:
 
Email Address*:
 
Home Phone*:
 
Work Phone*:
 
Address*:
 
City*: State*: Zip*:
Employer*:
(if none enter NONE)
 
Work Hours*:
(if none enter NONE)
 
Occupation*:
(if none enter NONE)
I am a:

If other please indicate:
if current student are you a Pell Grant Student: Yes No
 
Tartan ID Number*: (if none enter NONE)
 
Quarter Requested*: Fall Winter Spring
 
Academic Year*:
Hours Requested:
Days
Time In
Time Out
Lunch
Monday
Tuesday
Wednesday
Thursday
Friday
 



Did You Know?
Sinclair is the largest regional provider of online education, with more than 180 different online courses.
Sinclair awards on average $29 million in financial aid and scholarships each year.
Out of 1,200 community colleges in the nation, Sinclair is one of 20 board member colleges of the League for Innovation in the Community College.
Sinclair is one of only 12 Vanguard Learning Colleges in the U.S. and Canada, named for our "outstanding record of achievement in learning-centered education."

Courseview Campus Center | Englewood Learning Center | Huber Heights Learning Center
Online Learning | Wright-Patterson AFB
Privacy Statement | Security Policy | About this Site | Site Map | Contact Us
444 West Third Street, Dayton, Ohio 45402 | 1.800.315.3000
© 2008 Sinclair Community College   All Rights Reserved