Iowa State University
College of Human Sciences


Child Development Laboratory School

Child Enrollment Application

Child Enrollment Application

The following application form can be completed and electronically mailed directly to the Child Development Laboratory School. Children are selected from the pool of applications based on age and gender using a lottery system. Priority is given to children with identified special needs that can be accommodated in group care. Date of application and association with the University are not considered in the selection process. Siblings of children currently enrolled in the Lab School will receive special consideration, but no guarantee is made that siblings will be enrolled.

A $25.00 nonrefundable processing fee is due when the child is accepted for enrollment in a program and the deposit fee of $300.00 is due upon acceptance into the program.

Note: Transportation is the responsibility of the parents.

A monthly sliding scale tuition rate based on three income categories is used

Information about the Child

* Required Fields

Child's Name *Last Name:
  First Name:
*Gender Male
Female
Unknown
*Due date or date of birth Month: Day: Year:

Siblings

* Required Fields


Information about the Parents

* Required Fields

Father's Name
Father's Phone
Mother's Name
Mother's Phone
Address
Home Phone
Cell Phone
E-mail
*Language Spoken at Home:
Highest level of education father completed: High School
Bachelor's Degree
Masters Degree
Doctoral Degree
Other
Highest level of education mother completed: High School
Bachelor's Degree
Masters Degree
Doctoral Degree
Other
*Total Annual Family Income: $0 - $25,000
$25,000 - $50,000
$50,000 - $75,000
Over $75,000
*When would you like the child to begin? Month: Day: Year:
Special needs of child:
Additional Comments: