Wait List Form
Today's Date
Child's Name
Birth Date (MM/DD/YYYY)
Guardian #1
Home Phone
Guardian #2
Home Phone
Guardian #1 Work Phone
Guardian #2 Work Phone
Address
City
State
ZIP
E-mail
Preferred Enrollment Date
Guardian #1 Employer
Guardian #2 Employer
How did you hear about RSCC?
Seeing Sign/Building
On the Web
Print/Radio advertisement
Recommendation
Other
Referred By (If applicable):