Kids Junction - Information Request Form

"The staff treats every child like their own; it is truly a family."

"Not only do the teachers and staff educate and care for my children, they help to build their confidence and character through formal activities and personal example."

They are lucky to be able to attend Kids Junction

I want to sincerely thank you and your team for taking such good care of my son, (in the after school program). I know he has especially enjoyed the various craft projects.

I work with over a thousand schools in Wisconsin and Northern Illinois, and it’s very clear to me...

Personal and Contact Information:
Parent First Name:	Parent Last Name:
Phone:	Best Time to Reach You by Phone:
email: *	Current Preschool/Child Care Situation:


Child 1 DOB:	Child 2 DOB:
Estimated Start Date - Child 1: Immediate 2 Weeks 1 Month Other:	Estimated Start Date - Child 2: Immediate 2 Weeks 1 Month Other:
Desired Program - Child 1: Infant (6 weeks - 12 months) Toddler (1-2 years) Early Preschool (2-3 years) Preschool (3-4 years) Pre-K (4-5 years) Morning Preschool (3-5 years) Before/After School (6-12) School Age Summer Camp (6-12)	Desired Program - Child 2: Infant (6 weeks - 12 months) Toddler (1-2 years) Early Preschool (2-3 years) Preschool (3-4 years) Pre-K (4-5 years) Morning Preschool (3-5 years) Before/After School (6-12) School Age Summer Camp (6-12)

School :	School :
Schedule Notes:

What parents are saying about us:

Kids Junction - Information Request Form

Personal and Contact Information:

Additional Information: