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Thank you for your application to BlueSkies for Children.

Our goal is to review applications as quickly as we can, usually every 2-3 weeks and once we do, we will respond right away. There is a $50 application fee which will you will be prompted to pay after completing this form. Once submitted, you will receive a confirmation email. If you do not receive a confirmation email, or are having difficulty paying the application fee, please contact us at info@blueskies4children.org. Your application is not complete until we have received your application fee.

If you have questions or concerns, please feel free to contact us any time at info@blueskies4children.org.

Thank you!

1st Parent/Caregiver First Name *

1st Parent/Caregiver Last Name *

First and Last Name of Second Parent/Caregiver

Primary email address *

How did you hear about BlueSkies? *

Street *

City *

State *

Zip Code *

Primary Phone *

Secondary/Cell Phone

Sex of the Child *

Male

Female

Decline to State

Unknown

Name of Child ("Baby" if not known) *

We strive to create and sustain an environment that is highly diverse and inclusive of numerous identities. Please share as much information about your identities as you are comfortable with to help us build a diverse community - e.g. race, family structure, cultural background, neurodiverse etc. (BlueSkies does not discriminate on the basis of race, color, religion, gender identity or expression, sexual orientation, ability, national or ethic origin)

Child's Birth Date (or Estimated) * +

Preferred Start Date * +

Alternative Start Date *

I can start later

I can start earlier

I have flexibility

I may be eligible for financial aid and would like to learn more about it.

Is there anything else you'd like us to know about your family? *

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