Children's Learning Center Application

Green Room

Child's Full Name

Please check the session that you are enrolling your child for:


* Your child must be 15 months old by the first day of the semester.

Name of Person Filling Out Form

Are you on financial aid?

If yes, what kind?

Please select what applies to you:

May we send texts to this number?

Please indicate below the days/times you would like to enroll your child in the Children's Learning Center. All schedules begin ten minutes before the hour.
For example, if you are in a class from 1-2:20 p.m., you would contract from 12:50-2:50 p.m.
A non-refundable enrollment fee for the Green Room is $25 for the Fall and $30 for the Spring semesters. The additional $5 fee covers mandatory vision/hearing screening. Fees are required before your child’s services begin. All fees and payments are to be paid in Registration (A-258), either in person or over the phone ((815) 455-8588). The Children's Learning Center Application can not accept payments.