Waitlist – Kawai Kids™

Desired Start Date

Mother's Name

First Last

Father's Name

First Last

Mother's Phone Number

Father's Phone Number

Mother's Email Address

Father's Email Address

Mother's Employer

Father's Employer

Child's Name

First Last

Child's Date of Birth

Child's Gender

Is child potty trained?

Yes

No

Does your child have any special needs that the staff should be aware of? If so, please explain:

Desired Location

Montebello Home Childcare

Alhambra Childcare Center

Open to both

Desired Schedule

5 Days (Monday to Friday)

3 Days (Monday, Wednesday, and Friday)

2 Days (Tuesday and Thursday)

Kawai Kids™ hours of operation are from 7 am - 6 pm

Start time being requested for child care

Start Time

:

Ending time being requested for child care

Ending Time

:

How did you hear about Kawai Kids?