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Working Jours : Monday - Friday, 05:30 am - 11:30 pm & Saturday 06:00 am - 03:30 pm
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Enrollment Application
Home
Programs
About Us
Contact Us
Enrollment Application
Enrollment Application
Home
Enrollment Application
Ready to Join Our Village?
Start Your Child’s Enrollment Application
Enrollment Application
Child Information
Child's Name
*
Birthdate
*
Age
Sex
Tel
*
Address
*
Preferred Daycare Location
*
4 Chipmunk Dr, Fleetwood, PA 19522
City of Reading PA
Please select the Happy Village Daycare location where you would like your child to enroll.
Mother Information
Mother's Name
Tel
Address
Place of Employment
Telephone
Employment Address
Father Information
Father Name
Tel
Place of Employment
Address
Telephone
Employment Address
Parent Signature
Date
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