Me-mun-see-Hah-kee-hah-kun “Our Children’s Garden” Early Learning Center
Address: 810 Delaware Drive Phone: 405-247-2448
Anadarko, OK. 73005 Fax:
Child’s Name: ____________________________________ Date of Birth: __________________
Tribal Affiliation: __________________________________ Roll Number: __________________
Preferred Start Date: _____________________
Opening October 1
st
2020
Specify Days and Times Child Care is needed:
Monday
From: ___________________
To: ______________________
Tuesday
From: ___________________
To: ______________________
Wednesday
From: ___________________
To: ______________________
Thursday
From: ___________________
To: ______________________
Friday
From: ___________________
To: ______________________
Comments:___________________________________________________________________________
_____________________________________________________________________________________
____________________________________________________________________________________.
Staff Use Only:
Did parent or guardian provide a work or school schedule? Yes______ No _______
If No, when will this be available? _____________________________________________________