We encourage you to schedule a tour before applying. Contact our director, Lisa Kampwirth, to schedule a tour.

Please note our application includes a $50 non-refundable application fee.

Complete one application per child:

Child’s Name *

First

Last

Date of Birth

Sex

Program for Which You Are Applying *Full Day 2’s (Child must be 2 by September 1)Full Day 3’s (Child must be 3 by September 30)Full Day 4’s (Child must be 4 by November 30)Kindergarten (Child must be 5 by November 30)

Select one.

Parent/Guardian Information

Parent #1 Name *

First

Last

Parent #1 Email *

Parent #1 Cell Phone *

Parent #1 Home Address

Address Line 1

Address Line 2

City

IllinoisAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingState

Zip Code

Parent #2 Name

First

Last

Or write n/a if not applicable

Parent #2 Email

Parent #2 Cell Phone

Parent #2 Home Address

Address Line 1

Address Line 2

City

IllinoisAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingState

Zip Code

Complete if other than address #1.

Is there any additional information you’d like to share about your child or family?

Is your child a sibling of a currently or formerly enrolled child at Total Child? *

• Yes
• No

Are you a member of First United Methodist Church? *

• Yes
• No

Would you like to apply for financial assistance?

• Yes
• No

Download the financial aid application and email the completed form to director@totalchild.org.

How Did You Hear About Us? *

or #1 Birth

Application Fee

$50, non-refundable

Credit Card Information *

Card

Name on Card

Submit