Affordable Childcare Enrollment | Discovery Junction

Enrollment

Please complete the form below to apply for enrollment. We will reach out to you to discuss bringing your child into our development center.

If you would prefer to fill out a paper enrollment application, please print this document out and bring it to our center at 50 West Market St, Campbelltown, PA 17078.

If you have questions, contact us here or call us at (717) 838-6211.

Enroll

Child's Full Name(Required)

First Middle Last

Child's Birth Date(Required)

Child's Address(Required)

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

Second Child's Full Name

First Middle Last

Second Child's Birth Date

Second Child's Address

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

Parent/Guardian's Name(Required)

First Last

Parent/Guardian's Phone(Required)

Parent/Guardian's Email(Required)

2nd Parent/Guardian's Name

First Last

2nd Parent/Guardian's Phone

2nd Parent/Guardian's Email

Desired Program(Required)

Second Child's Desired Program(Required)

What date do you roughly hope to enroll by?(Required)

Full time or part time?

Full Time (5 to 10 hours a day)

Part Time (1 to 5 hours a day)

How did you hear about Discovery Junction?

CAPTCHA

Name

This field is for validation purposes and should be left unchanged.

Once you’ve filled out this form, we will reach out to you regarding the next steps for your child’s enrollment. Visit the Policies and Forms page for more information about policies at our center, and for printable links to various forms you may choose to fill out prior to meeting with us.

Please note that there is a registration fee of $40 due by the time of enrollment, and $25 for additional children (non-refundable). If you have more than two children to register, you will have to fill out this form for each additional child(ren). Make sure you hit “Send” before leaving the page to fill out forms for other children. If you have questions, please call us at (717) 838-6211

Enrollment

Enroll

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