"Waiting List Information Form" - Georgia (United States)

Waiting List Information Form is a legal document that was released by the Georgia Department of Early Care and Learning - a government authority operating within Georgia (United States).

Form Details:

  • The latest edition currently provided by the Georgia Department of Early Care and Learning;
  • Ready to use and print;
  • Easy to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of the form by clicking the link below or browse more documents and templates provided by the Georgia Department of Early Care and Learning.

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Download "Waiting List Information Form" - Georgia (United States)

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Waiting List Information Form
Please clearly print the name as it appears on the birth certificate
Child’s Last Name
| | | | | | | | | | | | | | | | | | | | | | | | | |
Child’s First Name
| | | | | | | | | | | | | | | | | | | | | | | | | |
Child’s Middle Name
Name Suffix (Jr, Sr, II, III)
| | | | | | | | | | | | | | | | | | |
| | | |
Last 4 Digits of SSN (if provided)
Date of Birth (M/D/Y)
Gender
- ___ ___ ___ ___
____/____/________
M
F
Home Address
City
State
Zip
GA
County of Residence
Date Started on Waiting List (M/D/Y)
____/____/________
Parent/Guardian Name
Phone Number
** Directory information on this form may be shared with
Bright from the Start: Georgia Department of Early Care and Learning
Parent/Guardian Signature
Date
Waiting List Information Form
Please clearly print the name as it appears on the birth certificate
Child’s Last Name
| | | | | | | | | | | | | | | | | | | | | | | | | |
Child’s First Name
| | | | | | | | | | | | | | | | | | | | | | | | | |
Child’s Middle Name
Name Suffix (Jr, Sr, II, III)
| | | | | | | | | | | | | | | | | | |
| | | |
Last 4 Digits of SSN (if provided)
Date of Birth (M/D/Y)
Gender
- ___ ___ ___ ___
____/____/________
M
F
Home Address
City
State
Zip
GA
County of Residence
Date Started on Waiting List (M/D/Y)
____/____/________
Parent/Guardian Name
Phone Number
** Directory information on this form may be shared with
Bright from the Start: Georgia Department of Early Care and Learning
Parent/Guardian Signature
Date