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IU Childcare Waitlist Application
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Submit a New Application
Edit Existing Application
Admin
Child's Information
Child's First Name
*
*
Child's Last Name
*
*
Child's Gender
*
Male
Female
Non-Binary
Unknown
Child's DOB
*
*
If pregnant, please enter Expected Due Date in place of Date of Birth.
Primary Parent/Guardian's Information
Primary Parent/Guardian First Name
*
*
Primary Parent/Guardian Last Name
*
*
Primary Parent/Guardian Email
*
*
*
Confirm Primary Parent/Guardian Email
*
*
*
Primary Parent/Guardian Phone Number
*
*
Please type phone number without dashes or parentheses (Example: 18121234567)
IU Affiliation
*
Current IU Faculty, Staff, or Student
IU Health
Community
Secondary Parent/Guardian's Information
Secondary Parent/Guardian First Name
*
Secondary Parent/Guardian Last Name
*
Secondary Parent/Guardian Email
*
*
Secondary Parent/Guardian Phone
*
Please type phone number without dashes or parentheses (Example: 18121234567)
Facility Options & Age Ranges
Campus Children's Center (CCC): 0 - 5 years
Campus View Child Care Center (CVCC): 0 - 3 years
Hoosier Courts Nursery School (HCNS): 3 - 5 years
Facility Preferences
Facility Selection
*
Please select your facility preference(s) below using the drop down arrow. You may select more than one option.
HCNS Schedule (Required if HCNS is Selected Above)
Please select your HCNS schedule preference(s) using the drop down arrow. You may select more than one option.
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