Child's Information


Parent/Guardian #1 Information

Parent/Guardian #2 Information

Program Options

Medical Information

The personal information collected in this waitlist application will only be used by Campus Childcare Inc., for administrative purposes, including assessing and processing the application for enrollment purposes in Campus Childcare Inc. The information will not be disclosed without your consent except as required by law. If you have any questions about this collection and use of your personal information, please contact Tracy Rose, Executive Director, at (709) 864-4728.