First Church of the Brethren
Child Development Center
2710 Kingston Road
York, PA 17402
717-755-6390; 717-755-1382 fax
CDC@yorkfirst.org

Online Waiting List Application:
(Please be sure to include at least one phone
number on your application. We are not
able to contact you without a phone number.)
Date:
Child:
Birth/Due Date:
Child:
Birth/Due Date:
Child:
Birth/Due Date:
Care Date:
Parent's Name:
_________________
Home Phone:
Work/Cell:
Email:
Tour Requested - Yes - No
  


Click here for a printable form:

Please mail or fax your
completed application to the
address/number listed on
this form

Your child’s name will be
placed on our waiting list.
The receipt of this
application does not
guarantee enrollment into the
Child Development Center.

Thank you for considering us
for your child care needs.



We are the Building
Blocks to a great future!


Office Use Only:

Date Received:
Classrooms:
Scheduled Tour: