Tot's Place Waitlist Application

Care Term Needed:

Fall

Winter

Summer

Child's Information:

(MM / DD / YYYY)

First name:		Date of Birth:	/ /
Last name:		Middle initial:

Mother's or Guardian 1's Information:

First name:

Last name:

Middle Initial:

Father's or Guardian 2's Information:

First name:

Last name:

Middle Initial:

Address:

Home Phone:

( ) -

Work Phone:

( ) -

City:

Alt. Phone:

( ) -

State:

Zip Code:

Email:

Please Select One:

FSU Student

FSU Staff/Faculty

Other

(the above information will not effect your childs enrollment status)

Waiting List Terms: (please read carefully before submitting this form)

This application will be active for one year from the date of receipt by Tot's Place. Waiting list applications will be processed by the date received. This application does not guarantee your child a space, we will contact you in the event of an open space. Siblings of children currently enrolled will be placed at the top of the waiting list for the appropriate age group. Receipt of the $40 registration fee and a completed enrollment packet will secure the child's spot. Calls (notification of an opening) are made on a space available basis. It is the applicant's responsibility to inform Tot's Place of changes regarding waiting list information (if we are unable to contact the person through the given information the application will automatically be voided).

I understand and agree to the waitlist terms. The information you submit via this form will be emailed directly to the Director of Tot's Place.