Complete the on-line registration form below for the Mequon Center and click the SUBMIT button.
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Starting Date   Child's Name   Age   Birth Date   Names of Parents/Guardians   Home Address   Home Phone     Mother's Work    Phone   Father's Work     Phone     PLEASE INDICATE BELOW THE DAYS AND TIMES IN WHICH YOU WILL BE NEEDING CHILD CARE:     Mon Tue Wed Thu Fri Starting Time: Ending Time:   Is van service required?                 YES     NO   Is your schedule consistent?         YES     NO   If NO, please describe below     Mequon