Child Development Center


Truman College Child Development Lab School Enrollment and Information Request Form
Name
Relationship to Child
Address
City
Zip
Phone
Second Phone
Email
Please check one:
Truman Student
Faculty / Staff
Community Member
Are you?
Seeking Information
Applying to the Center
If you are seeking information please enter your questions or requests into the area below:

If you are applying to the program for a child or children please fill out the following information:
When would you want your child to begin attending the center?

Information about your child or children:
Child's Name	Birth Date	M F
Child's Name	Birth Date	M F
Child's Name	Birth Date	M F
Information about your family:
Number of People in the Family
Source of Income
Estimated Yearly Income
How did you hear about the Truman College Child Development Center?