UIC Children's Center Application

 

answer must be date like mm/dd/yyyy

  start dateclick calendar to choose a start date    date rules

Question 3

requiredGender
 
 

Question 6

requiredIs your child toilet trained?
 
 
 

Parent/Guardian Information

 

 
Please include street address, city, & zip code

Question 9

requiredHome Address
Please include street address, city, & zip code
 
 

answer must be phone number with area code like 217-333-1000

  phone number with area code rules

 

If you are Non-UIC or have not yet been assigned a UIN please type NA

If you are Non-UIC or have not yet been assigned a UIN please type NA
 

 

 

answer must be phone number with area code like 217-333-1000

  phone number with area code rules

 

 

 
Please include street address, city, & zip code

Question 20

Home Address
Please include street address, city, & zip code
 
 

 

answer must be an email address

  email rules

If you are Non-UIC or have not yet been assigned a UIN please type NA

If you are Non-UIC or have not yet been assigned a UIN please type NA
 

 

 

answer must be phone number with area code like 217-333-1000

  phone number with area code rules