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For all inquiries concerning enrollment and availability or to schedule a tour contact:

Creative Child Care West Center - Phone: (614) 276-2737 · Email: west@creativechildcareinc.com

For all other inquiries contact:

Corporate Office – Phone: (614) 863-3500 · Email: corporate@creativechildcareinc.com

Or you can complete the form below:

Name(Required)

First Last

Email(Required)

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Phone(Required)

Please check one of the following:

General Inquiry not concerning enrollment information

I need enrollment information or would like to schedule a tour

Please explain the nature of your inquiry

Your Relationship to Child(Required)

I am interested in (check all that apply):(Required)

Infant Care (6 weeks – 18 months)

Toddler Care (18 months – 3 years)

Preschool (3 years – 5 years)

Early Head Start Program

Head Start Preschool Program

I qualify for PFCC(Required)

Yes

Not Sure

Publicly Funded Child Care Assistance (PFCC) - If you are working or going to school, you can apply for PFCC, which is help with paying childcare through the county department of jobs and family services. It is based on your income, family size, and hours worked or going to school. You may be required to pay a parent copayment.

Number of Children Interested in Enrolling?(Required)

Child 1 Information

Child's Name(Required)

First Last

Child's Birth Date(Required)

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Child 2 Information

Child's Name(Required)

First Last

Child's Birth Date(Required)

MM slash DD slash YYYY

Child 3 Information

Child's Name(Required)

First Last

Child's Birth Date(Required)

MM slash DD slash YYYY

Child 4 Information

Child's Name(Required)

First Last

Child's Birth Date(Required)

MM slash DD slash YYYY

Child 5 Information

Child's Name(Required)

First Last

Child's Birth Date(Required)

MM slash DD slash YYYY

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