Y Learning Center Great Start Readiness Program Inquiry Form

Complete and submit the online form to start the enrollment process.

You’ll receive an email response from the YLC director confirming your submission and what to expect.

Name(Required)

First Last

Email(Required)

Phone(Required)

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Child's Name(Required)

First Last

Child's Date of Birth (must be four on or before 12/1/23)(Required)

Any special needs or food allergies?(Required)

Yes (please explain in next section)

If yes, please explain special needs or food allergies

Do you receive DHS subsidy for your child care?(Required)

Yes

Does your child need before and/or after care?(Required)

Before care only (7am-8:20am)

After care only (3:30pm-5:30pm)

Both before care and after care

For more information or to enroll your child at the Y Learning Center, call (231) 375-2126 or contact us below.

Y LEARNING CENTER