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Blossom Childcare and Learning Center
2945 Douglas Avenue
Bellingham, WA
98225

Tel.360.752.2699

E-Mail: info@blossomchildcareandlearningcenter.com

 



To be placed on our waiting list, fill out this pre-registration form and send us
a check for $50.00 to the address above. Upon enrollment the $50.00 will be
applied to the registration fee.
Today's Date:
Child's Name: *
 Birthdate: *
Child's Name: *
 Birthdate: *
Child's Name: *
 Birthdate: *
Desired Start Date(s):
*Refer to the Tuition page for programs and scheduling options*
Program(s) Desired
 Schedule(s) Desired: Include Days & Times
Parent(s)(Legal Guardian) Name: *
Phone(Home):
 Phone(Work):

* Required to submit this form










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