Columbia Baptist Church
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Child Development Center Waitlist Form
CDC Wait List
*
Required
Email Address
*
Address Line 1
*
Address Line 2
City
*
State
*
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AA
AE
AK
AL
AP
AR
AS
AZ
CA
CO
CT
DC
DE
FL
FM
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MH
MI
MN
MO
MP
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
PR
PW
RI
SC
SD
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
Zip Code
*
Area Code
Phone Number
Home Phone
*
Work Phone
Ext:
Cell Phone
Parent's First Name
*
Parent's Last Name
*
Do you have a child currently enrolled in CDC?
*
No
Yes
If yes, enrolled child's name:
Child #1 Name:
*
Child #1 date of birth (mm/dd/yy)
*
Child #2 Name:
*
Child #2 date of birth (mm/dd/yy)
*
Preferences:
Morning Classes (3 to 4 Years old)
Full Day Classes (2-1/2 to 5 Years Old)
Types of Morning Classes:
3 Year Old Classes 2-Day (Thu/Fri)
3 Year Old Classes 3 Day (Mon/Tue/Wed)
4 Year Old Classes 4-Day (Mon-Thu)
4 Year Old Classes 5-Day
This application places your child on the Child Development Waiting List. This is NOT an application to the Center. Please email Kris Solberg (ksolberg@columbiabaptist.org) if you wish to remove your child from this list or if your address or phone numbers change and you wish to remain on the waiting list. We will notify you as soon as possible. Thank you!
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