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Great Bay Kids
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Waitlist Form
Check if appropriate (if applicable)
DCYF/Foster Care Child
Currently enrolled in the GBK
Sibling currently enrolled in GBK
Eligible for NH Child Care Scholarship Assistance
Sibling currently on GBK Wait List
Parent/Guardian
First Name *
Last Name *
Street Address *
Apartment, suite, etc
City
State/Province
ZIP / Postal Code
Email Address *
Phone
Child
First Name *
Last Name
Date of Birth *
Anticipated Enrollment Date *
Areas of Interest
Program Interested In
School Age Summer Camp @LSS
School Age Program @LSS
Exeter Center
Pease Center
School Age Summer Camp @Pease
Age Group Interested In
Infants
Young Toddlers
Toddlers
Preschool
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
Scheduling Needs
Monday
Tuesday
Wednesday
Thursday
Friday
Hours (i.e. 8 am to 4 pm)
How did you hear about our agency?
I understand I am not placed onto the waitlist until I have paid the NON-REFUNDABLE $75 Waitlist Fee via cash or check.
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