Waiting List Application

ELC is committed to serving a diverse population of children and families in our program. Please fill out the application below to get on the waitlist. For more information on our Waiting List Policies & Procedures click on the link below.

Waitlist Application - No NKU

Note: There is a $55 (non-refundable) registration fee

"*" indicates required fields

PERSONAL INFORMATION

Name
Address
Are you a student?*
Are you employed at UC or NKU?*

DETAILS OF CARE NEEDED

MM slash DD slash YYYY
Type of care needed*
Preferred Site*
Do you have more than one child needing care?*
(If yes, please fill out 1 form per child. The $55 registration fee is due for each child)

FINANCIAL ASSISTANCE

Do you qualify for any type of assistance?*