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Families | Better Kid Care Registration Form |
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2009
Spring Better
Kid Care
Payment required with registration. No Phone or e-mail registrations accepted. * Registrations received after maximum attendance of 25 reached will automatically be scheduled for the overflow date. Name _______________________________________________ Day Care ____________________________________________ Street _______________________________________________ City/State/Zip _________________________________________ Phone _____________________ Email ____________________ Last Five Digits of Social Security #______________________ Type: ___Family ___Group ___Center ___Relative/Neighbor County ________________ Amount enclosed _____________ No refunds after registration
deadline.
Mail to: |
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Penn
State | College of Agricultural
Sciences | Cooperative Extension
& Outreach
This page last updated Thursday, July 9, 2009 13:01 Copyright Information This publication is available in alternative media on request. Penn State is an Affirmative Action, Equal Opportunity University. This site is a product of Penn State College of Agricultural Sciences. Please e-mail us with your questions, comments or suggestions at BlairExt@psu.edu. |
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