Waiting List – Academy of Early Childhood Learning

An application and $250.00 non-refundable deposit is required to guarantee a spot on the waiting list. This does not guarantee your preferred start date. Call for availability and waiting list information.

Mail $250 deposit to:

Academy of Early Childhood Learning
3210 S Providence Rd.
Columbia, MO 65203

Please fill out one application for each student and class.

Child's Information
Date you would like to start*
Name*
First Last
Gender*
- Male
- Female
- Unknown
Date or anticipated date of birth*
First Parent/Guardian
Name
First Last
Address*
Street Address City State ZIP Code
Home phone*
Cell or work phone
Email*
Occupation
Employer
Is there a 2nd parent/guardian*
- Yes
- No
Second parent/guardian
Name
First Last
Address
Street Address City State ZIP Code
Home Phone
Cell or work phone
Email
Occupation
Employer
Additional Information
Is there anything else we should know?
- Please add me to the Academy mailing list

Child's Information

First Parent/Guardian

Second parent/guardian

Additional Information