Heavenly Kids Center for Learning Application Inquiry

400 East Mound Street, Columbus, Ohio 43215
You MUST Submit before leaving this form or ALL entries will be lost.

Child

Enter the child's full name (example: use Joseph not Joe)
Gender *
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Program

Select the programs and days you would like your child to attend
Preschool is for children from birth to age 5 on September 1
Preschool is available for children in Head Start
Program *
Days *
Children must be registered for a minimum of 25 hours of care per week.

Parent or legal guardian

Enter telephone number as 10 digits with no other characters
Payment method *