RSVP 2 — Las Luciérnagas

Las Luciérnagas Application

Please fill out this form to apply for a space in Las Luciérnagas.
When you are finished please submit your one-time $50 application fee below.
*Application fee is waived for families who receive ELS vouchers

Which School Year are you Applying For?

Student Name

First Name

Last Name

Student Date of Birth

YYYY

Student Gender

Parent 1 Name

First Name

Last Name

Parent 1 Email

Parent 1 Phone

(###)

###

####

Parent 1 Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Parent 1: Should we contact you in

Parent 2 Name

First Name

Last Name

Parent 2 Email

Parent 2 Phone

(###)

###

####

Parent 2 Address

*If different from Parent 1

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Parent 2: Should we contact you in

Other Primary Caregivers

If there are more than 2 primary caregivers in your child's life, please list their name, email, phone number, address, and primary language below.

What is your family's home language?

Has your child qualified for a subsidy voucher from Children's Council or Wu Yee Children's Services?

If you have a subsidy voucher, please list the type of voucher here:

Schedule Request: 1st Choice

Schedule Request: 2nd Choice

Child's Language Proficiency: Spanish

Child's Language Proficiency: English

Tell us about your family

Tell us about your child

Please tell us about the qualities you are searching for in an early childhood program.

Please add any further information you would like to share with us.

How did you hear about Las Luciérnagas?

Have you attended a Project Commotion movement class?

Please check date of Open House you have attended/plan to attend

Date 1

Date 2

Date 3

Pay Application Fee