ELLI Inquiry Form

Completion of this form does not guarantee enrollment, as this is NOT a registration form.

* Indicates Response Required

PARENT/GUARDIAN INFORMATION

First Name *

MI

Last Name *

Address *

City *

State *

Zip Code *

Primary Email Address * 🛈

Confirm Email * 🛈

Primary Phone *

CHILD'S INFORMATION

Child's Name *

MI

Last Name *

Birth Date (MM/DD/YY) * +

Desired Start Date * +

DESIRED LOCATION

Select your desired location from the dropdown: *

How did you hear about us? *

Is this person an ELLI Parent or Museum Member? 🛈

What is the Other Website?

What is the Other Social Media?

Where was the Billboard?

What Newspaper/Magazine?

If yes, please list them below. *

0/500 characters

If yes, please list them below. *

0/300 characters

Parent/Guardian Signature

Stepping Stones Museum for Children, ELLI Lab School
Mathews Park, 303 West Avenue, Norwalk, CT 06850
or ellilabschool@steppingstonesmuseum.org.

For more information, please call 203 899 0606, ext. 216.

Completion of this form does not guarantee enrollment.
A registration fee and deposit is due upon acceptance to the program.

Stepping Stones Museum for Children is a non-profit 501 (c)(3) organization. All application and tuition fees go to teacher salaries, materials and programming and building/facilities maintenance.

In the museum	Word of Mouth
Stepping Stones Website	Other Website
Stepping Stones Social Media	Other Social Media
Billboard	Newspaper/Magazine
Norwalk Public Schools	Other Other