UIC Children's Center Application

UIC Children's Center Application

 

answer must be date like mm/dd/yyyy

  start datechoose a start date

requiredGender

requiredGender

requiredIs your child toilet trained?

requiredIs your child toilet trained?

Parent/Guardian Information

 

 

Please include street address, city, & zip code

requiredHome Address

requiredHome Address

Please include street address, city, & zip code

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

 

 

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

 

 

 

 

Please include street address, city, & zip code

Home Address

Home Address

Please include street address, city, & zip code

 

answer must be an email address

 

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