Young Children’s Center for the Arts

Registration

YCCFA Registration & Stripe Payment Form

Facility Address:
YCCA: 929 S. Water Street Philadelphia, Pa. 19147 (215-336-3324)

YCCAon2:
1714-20 S. 2nd Street Philadelphia, Pa 19148 (267-928-4808)

Application for Preschool 2024 - 2025

A $25.00 application fee must accompany the completed application. *The application will not be submitted unless you pay the fee.

We will alert you in January 2024 if we have an available spot for the 2024-2025 school year or if your child has been placed on our waiting list.

If we have availability and can accommodate your needs we will request a $500 non-refundable “deposit” to reserve your child’s placement (this “deposit” is applied to your total tuition bill)

About the Child

Fill out some information about the child you are registering.

Child’s full name

First Name

Last Name

Address

Address Line 1

Address Line 2

City

State

Zip Code

Child's Birth Date

Health Status

Location and Schedule

Please make some choices related to where and when you would like the child to attend.

Please select one or both locations

1714 S. 2nd Street

929 S Water St

No Preference

If you selected both locations, please let us know if you prefer one over the other (your child will still go on both waiting lists if you check off both locations).

Scheduled Days

Monday

Tuesday

Wednesday

Thursday

Friday

Flexible

Length of days (check all that apply)

Full days (8:30-3:30 p.m)

Morning Extended (Drop off before 8:30)

Afternoon Extended (Pick up after 3:30pm)

Afternoon Program Only (only available at YCCA- not YCCAon2) (3:15-5:30)

About the Parents

Fill out some information about the parents of the child.

First Name

Last Name

First Name

Last Name

Relationship

Marital status

Single

Married

Separated

Divorced

Living together

Is Parent #1 address is same as child?

Yes

Parent #1 Address

Address Line 1

Address Line 2

City

State

Zip Code

Is Parent #2 address is same as child?

Yes

Parent #2 Address

Address Line 1

Address Line 2

City

State

Zip Code

Parent #1 Phone/Mobile

Parent #2 Phone/Mobile

Parent #1 Email

Parent #2 Email

Occupation of Parent #1

Occupation of Parent #2

Best way to contact you (for non-emergencies)

Additonal Info

Names and ages of siblings, if applicable

How did you hear about our center?

Young Children’s Center for the Arts (“YCCA”) is a non-profit 501c3 organization that is dependent upon additional support to provide exceptional childcare and programming in the community. We require each YCCA family to volunteer throughout the school year at least once. Volunteer opportunities will be announced throughout the school year by email for your convenience.

References

Kindly list 2 people we can call for character references

First Name

Last Name

First Name

Last Name

Reference #1 Phone/Mobile

Reference #2 Phone/Mobile

Activities & Behavior

I am interested in having my child attend the preschool program at YCCA because I want him/her to….

Do you listen to music with your child?

Yes

Do you paint with your child?

Yes

Has your child ever finger painted?

Yes

Has your child ever played with play-dough or clay?

Yes

How often do you read with your child?

List several favorite books

Have you ever had to discipline your child for inappropriate behavior? If so, what strategies have you used?

Is your child articulate?

Yes

If not, have you taken him/her for a speech evaluation?

Yes

Age he/she crawled

Age he/she walked

Share a favorite day’s experience with your child

Is there anything else you would like to share with us about your child?

What activities (in or out of school) does your child enjoy most? What helps to boost his/her self confidence?

What situations cause your child to experience anxiety or stress? Which activities does he/she tend to avoid?

Which of your child’s emerging skills and traits are you most excited and pleased about? What do you see as particular strengths?

To ensure an appropriate educational and social preschool experience, YCCA reserves the right to request evaluations and/or documentation of past evaluations for children exhibiting “at risk” social, emotional, behavioral and/or educational development.

Has your child ever received services through Childlink (Birth to 3) or Elwyn Seeds (3-5)?

Are you concerned about any aspect of your child’s development? If so, please indicate the areas of development (i.e speech, physical, cognitive social) that are of concern to you.

Is your child currently enrolled in another program? If so, why are you looking to switch programs?

Young Children’s Center For The Arts provides its community with an inclusion program that warmly embraces each and every young child, regardless of race, religion, ethnicity, and development.

Approval & Payment

Parent name

This signifies parental approval.

First Name

Last Name

Date

Payment

You may pay using credit card

Registration Fee

Price: $25.00

Pay with Card (Stripe)

Additional Comments