CE Approved Document revised 10/27/10
EANES INDEPENDENT SCHOOL DISTRICT – CHILD DEVELOPMENT CENTER PROGRAM
CDC WAITING LIST APPLICATION
Return by mail to:
EISD Community Education/CDC Waiting List
601 Camp Craft Road
Austin, Texas 78746
Make $100.00 check payable to: EISD/CDC
Put Child’s Name in memo line
Child’s Legal Name:
Child’s Birthdate: ________/_________/________
I am applying for school year
Last, First, Middle
__10-11 __11-12
Parent/Legal Guardian Name(s) – include parents/guardian as applicable:
Last, First
Last, First
Legal Contact Address:
Street
City
Contact Phone Number(s):
Home E-mail address(es)
State
Business -
Zip
Cell –
CDC Eligibility (Check all that apply)
_______My child will be eligible to attend EISD schools
____ My child will be
years and ___ months
by September 1, 20________
Campuses locations are not guaranteed; please
indicate your preference by number (1st choice, 2nd
choice, etc.)
Barton Creek ________ choice
Cedar Creek ________ choice
Eanes
________ choice
Valley View ________ choice
I would like your child to be considered as a Peer
Mentoring in the ELT Program (see website for
additional information)
How did you hear about the CDC?
___________ YES
Is your child currently enrolled in the child care
center?
If yes, where?
____________ NO
Parent Signature: ______________________________________ Date Signed: __________________________
For Internal Use Only
Date Received:
Check enclosed - #
Called for spot:
Tour scheduled:
Classroom offered:
Child Placed:
Amt: