House at Pooh Corner

Family Daycare...

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Online Application

Welcome to the House at Pooh Corner Family Daycare website!

Please remember to fill out ALL required fields.

*Child's First Name *Child's Middle Name *Child's Last Name *Child's Birth Date *SS# *sex *Parent's Name(s) *SS# *Employer and Employment Address
*Work # *Emergency Contacts (Name, Address, Phone)
*Child's Physician (Name, Address, Phone)
*What kind of care are you applying for?
Infant $120 per week Full-Time
Infant $75 per week Part-Time
Toddler $100 per week Full-Time
Toddler $65 per week Part-Time
Drop In Care $25
Before/After School Care $50 per week
*By typing my name as my signature, I am stating that I have answered the above truthfully and to the best of my knowledge.

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