Enrollment | Luma Learning Centers

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First Name

Last Name

Email

Home Address

Phone

How many children will be attending? *

1

2

3

4

5

Services Needed

Infant

Toddlers

Pre-K

Afterschool

How soon do you need to start childcare services? * Required

As soon as possible

1- 2 weeks

2 -3 weeks

1 month

Hours and Day Needed * Required

Mornings Shift

Afternoon Shift

Afterschool

Weekends

Drop-In Only

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