Inquiry VBDC Inquiry Form For more information please CALL US at 973-378-5906 Or, fill out the form below and a member of the administrative staff will contact you Today's Date Student #1 (required) (If multiple students, please enter oldest child's info first) First Name Last Name Date of Birth (required) Preferred Start Date Choose one - there is no part time option Full Time Aftercare Program Interest Select an option Infant/Toddler Preschool/Pre-K Summer Program SOMSD Preschool Partnership Beforecare Aftercare Student #2 (If adding a second child, please fill out all of this section.) First Name Last Name Date of Birth Preferred Start Date Choose one - there is no part time option Full Time Aftercare Program Interest Select an option Infant/Toddler Preschool/Pre-K Summer Program SOMSD Preschool Partnership Beforecare Aftercare Parent's / Guardian's Name (required) First Name Last Name Email (required) Phone 1 (required) Phone 2 Relationship to Child (required) Select an option Mother Father Grandmother Grandfather Legal Guardian Other How did you hear about Village Babies Development Center, LLC:(required) Online Drive By Referred By - enter name below Other - enter below Referred By: Other: Would this be your child’s first experience attending an early childhood development center? Yes No If no, please tell us a little about your child’s previous experience: Additional Information / Comments Submit