Crosstown Learning Center Interest Form Crosstown Learning Center Interest Form Crosstown Learning Center Interest Form Before completing this form, please be aware of the following information: We only enroll children from ages 6 weeks to 5 years old. If you are currently expecting a child, or have a child younger than 6 weeks, we encourage you to apply ahead of time. We are a full time care facility, operating from Monday to Friday. We do not accept children on a part-time basis. The funding sources we accept include DHS, Tribal Pay, or Private Pay. Tuition costs can be found here. Para ayuda en español, por favor llame a nuestra officina al (918) 582-1457. Con gusto haremos traducciones para ayudarle. Desired Start Date: * Parent/Guardian Name * Street Address * City * Zip Code * Email * Phone Number * Child First Name * Child Last name * Child Birthday * Does your child have any known food allergies? * YesNo Have you ever had prior enrollment at Crosstown (older child, sibling, etc)? * YesNo What are the name(s) of the children previously enrolled? Separate by comma Please indicate how you plan to pay for your child's care * Private Pay (Cash, Check, Card) DHS Subsidy Tribal Pay Submit If you are human, leave this field blank.
