Enrollment Request Form

Thank you for considering enrolling your child with Big Minds Little Hands Learning Center! We know that this is a very important decision for your family. Please complete the Enrollment Request Form below and our Director will reach out to you soon!

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Child's Name *

First

Last

Child's Date of Birth *

Requested Enrollment Date *

Age Group of Child for Enrollment Date *

• Infant (6 weeks-1 year)
• Toddler (1-3 years)
• Preschool (3-5 years)

Parent/Guardian Name *

First

Last

Parent/Guardian Email *

Parent/Guardian Phone *

Any additional information you would like us to know:

Submit