Application for Enrollment

Please complete the following information in order to begin the enrollment process. You can also download a PDF version

Basic Information Name(s) of Parent(s) Name of Child Date of Birth Gender Female Male

Address Address
City State ZIP

Contact Information Home Phone Work Phone Mobile Phone Email address

Other How were you referred to our center? Are you affiliated with Hebrew Union College? Yes No If so, how? (Student, Staff Faculty, etc) What are your expectations of the child care center as far as your needs are concerned? What are your expectations of the child care center as far as your child's needs are concerned? When are you interested in starting your child in our child care center?

Thank you for your interest in our center. Please note that a $35.00 fee must be included with this application. Please send this fee to:

JELC - Application Fee
3101 Clifton Ave
Cincinnati, OH 45220

Jewish Early Learning Cooperative. 3101 Clifton Avenue, Cincinnati, Ohio 45220. 513-221-1979