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Bright Side Inquiry Form
Applicant Information
*
Indicates required field
Entering Semester
*
-- Select an Option --
Summer 2020
Fall 2020
Spring 2021
Child's Name
*
First
Last
[object Object]
Gender
*
Male
Female
Birth Date (MM/DD/YYY)
*
Applicant Address
Home Address
*
Address Line 2
*
City, State, Zip
*
Parent/Guardian 1 Information
Relationship to Child
*
-- Select an Option --
Mother
Father
Step-mother
Step-farther
Grandparent
Guardian
Other
Name
*
First
Last
Phone Number
*
Email
*
Parent/Guardian 2 (Spouse/partner of Parent/Guardian 1)
Relationship to Child
*
-- Select an Option --
Mother
Father
Step-mother
Step-farther
Grandparent
Guardian
Other
Name
*
First
Last
Phone Number
*
Email
*
How did you hear about us?
Source
*
-- Select an Option --
Internet
Facebook
Friend
Word of mouth
Drive by
Sign
Advertisement
Community Event
Other
If other, please explain
*
Additional Information
Questions/Comments
*
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Bright Side Early Care and Learning Center
"Where Children Always Shine"
Home
Programs
All Programs
Enhanced Education Due to Covid-19
Admission
Inquire
Photo Gallery
Our Center
Our Beliefs
Calendar
Careers
Staff
Contact
facebook