Waitlist Form

Would you like to enroll your child at Illumi Child Care? If so, please fill waitlist form below, or you can also download the form below in PDF format.

Download Waitlist Form

Fill the information in the form and return the completed form to us. You may email at: [email protected]

Fill the form & submit

PARENT INFORMATION:

Mother Name*

Mother Phone*

Father Name*

Father Phone*

CHILD INFORMATION #1:

Child's Full Name*

Date of Birth*

CHILD INFORMATION #2:

Child's Full Name

Date of Birth

ADDITIONAL INFORMATION:

Desired Start Date*

Email Address*

How did you hear about us?

Additional Information

Thank you for your interest in our daycare. We will review your request and contact you to confirm the date and time or to provide alternative options if necessary. We look forward to meeting you.