Join the Waitlist

CHILD’S LAST NAME*
CHILD’S FIRST NAME*
DATE OF BIRTH (mm/dd/yy)*
MM slash DD slash YYYY
ATTENDING SIR ADAM BECK?
- Yes
- No
NAME OF PARENT/GUARDIAN
ADDRESS
PHONE – HOME
PHONE – WORK
EMAIL ADDRESS
IS YOUR CHILD CURRENTLY IN A CHILDCARE CENTRE?
- Yes
- No
DOES YOUR CHILD HAVE ANY SPECIAL DEVELOPMENTAL NEEDS?
- Yes
- No
DOES YOUR CHILD REQUIRE ANY SPECIAL DEVELOPMENTAL SERVICES OR ASSISTANCE?
- Yes
- No
IS THIS A REQUEST FOR A SUBSIDY SPOT?
- Yes
- No
- Unsure
Requested Start Date
MM slash DD slash YYYY
Acknowledge
- I acknowledge I am submitting this application to be on the waiting list and it does not guarantee a spot in the Centre. If a spot becomes available at AAASI, families are contacted based on their place on the waiting list. An email will be the first form of contact and will be followed with three pone call attempts to contact a family within a seventy-two-hour (three day) time frame before we automatically remove them from our waiting list
Email
This field is for validation purposes and should be left unchanged.

AAASI | Alderwood Action After School Inc.