Enroll My Child : Enrollment & Eligibility : Our School & Programs : Clayton Early Learning

Enrollment Application

First Name (Required)

Last Name (Required)

Address (Line 1) (Required)

City (Required)

State (Required)

Zip (Required)

Phone (Required)

Email (Required)

Home Language

Referred by (Choose one of the following) (Required)

If other, type referrer here

Child First Name (Required)

Child Last Name (Required)

Birth Date / Due Date (Prenatal - Age 5) (Required)

Gender

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Is there anything you would like us to know about your child?

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