Online Waiting List Application

Thank you for your interest in enrolling your child in Fruit & Flower!

Tours are held two times a month and may be scheduled through the front desk staff or contacting us online. We’d love to have your family visit!

For more information on wait list or program questions please email Naomi Chavira

Select Campus Location:*
Child Information
Child's Name*
Birth Day / Expected Date*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Preferred Enrollment Date*
Please note that care may not be available on your desired date.
Previous Care
Financial Aid / Scholorship
Financial Assistance / Scholarship Request*
You must fill out the application for financial assistance/scholarship and return with this application.
You will be redirected to the Financial Assistance and Scholarship application after this waiting list application is submitted.
Custodial Parent #1 Information
Custodial Parent #1 Name*
Custodial Parent #1 Home Phone/Cell Phone*
Custodial Parent #1 Work Phone
Custodial Parent #1 Email
Custodial Parent #1 Occupation
Custodial Parent #1 Employer
Custodial Parent #2 Information
Custodial Parent #2 Name*
Custodial Parent #2 Cell/Home Phone*
Custodial Parent #2 Work Phone
Custodial Parent #2 Email
Custodial Parent #2 Occupation
Custodial Parent #2 Employer
Additional Information
Siblings Names and Birthdates
Additional Information
How did you hear about Fruit & Flower?
Vaccine Policy Compliance*
I understand Fruit & Flower's vaccine policy and that failure to comply will result in termination of care.
Initial for vaccine compliance / acceptance*
Waiting List Payment
Do you have any other children on the waiting list?*
PCC Waiting List Fee Type
PCC Full Waiting List Fee
Price: $100.00
PCC Staff / Faculty Waiting List Fee
Price: $75.00
NW Location Waiting List Fee
Price: $100.00
Total
$0.00
Scholarship Request : Yes/No
Financial assistance form attached: Yes/No
Date entered on waitlist:
Date follow up letter sent:
Age group child interested in attending:
Name
This field is for validation purposes and should be left unchanged.

Thank you for your interest in enrolling your child in Fruit & Flower!

Child Information

Financial Aid / Scholorship

Custodial Parent #1 Information

Custodial Parent #2 Information

Additional Information

Waiting List Payment

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