Application for Admission

Dear interested parent,

Talitha Koum currently has a waiting list for every classroom. Yet, we are happy for you to join that list. Please fill out the brief application below and hit SUBMIT. If an opening does occur, we will call you to come in and fill out the full enrollment form.

Today's Date *
Today's Date
Child's Name *
Child's Name
Child's Date of Birth *
Child's Date of Birth
Parent/Guardian Name *
Parent/Guardian Name
Parent/Guardian Phone Number *
Parent/Guardian Phone Number