Online Forms

Child Care Services Application

Thank you for your interest in Child Care Services at Camosun College. Our centers are popular places and we strongly recommend that you put your child on the waitlist as soon as you know you need care. In order to apply, please ensure that you fill out the entire form as incomplete forms will result in processing delays.

General Information

Child's first name: *

Child's last name: *

Birth date/Due date: *

Requested date of entry: *

Campus: *

Interurban

Lansdowne

Select all that apply

Primary Caregiver Information

Status: *

Camosun student

Camosun staff

Camosun faculty

Community member

Camosun ID: *

Format: C0123456

Program:

Department: *

First name: *

Last name: *

Street address: *

City: *

Province: *

Postal code: *

Format: A1A 1A1

Phone: *

Format: 250-555-1234

Alternate phone:

Format: 250-555-1234

Email: *

This address will be used to communicate with you about the status of your application.
You will receive a confirmation email at this address when you submit this form.

Secondary Caregiver Information

Status: *

Camosun student

Camosun staff

Camosun faculty

Community member

Camosun ID: *

Format: C0123456

Program:

Department: *

First name: *

Last name: *

Street address: *

City: *

Province: *

Postal code: *

Format: A1A 1A1

Phone: *

Format: 250-555-1234

Alternate phone:

Format: 250-555-1234

Email: