Child Care Interest Form | Madison College Apps

The Early Learning Campus (ELC) is a campus-based childcare for children ages 6 weeks - 5 years. Priority enrollment is granted to student-parents, particularly low-income students, to help them obtain their educational goals.

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Parent/Guardian Information

First Name

Last Name

Telephone

Street Address

City

State

Zip Code

Affiliation

Are you receiving a Pell Grant?

Have you completed the CCAMPIS Scholarship Application?

Yes

View the Scholarship/Funding Resources section of our Early Learning Campus page for more details; https://madisoncollege.edu/about/community/facilities/child-care

Are you receiving child care funding?

Yes

Select all that apply

City of Madison

UW Madison Tuition Assistance (CCTAP)

WI Shares

Other…

Session Information

Preferred Start Term

Year

Location

Truax Campus

Goodman South Campus

6 weeks - 4 years (Non-4K) Schedule

Complete if your child is in this age range and NOT enrolled in the MMSD 4K program. There is a two day per week minimum enrollment requirement. The center’s latest drop-off time is 10:00am. Exact hours of care are scheduled between the parent/guardian and the enrollment team. (Note: Available hours of care are different at the ELC-Truax and the ELC-South centers).

Questions	All Day
Monday	All Day
Tuesday	All Day
Wednesday	All Day
Thursday	All Day
Friday	All Day

Wrap Around Care for 4K Students

Complete for children who are eligible for or enrolled in the 4K program through MMSD. 4K hours are Monday - Thursday 8:30 am - 3 pm. Exact hours of care will be scheduled between the parent/guardian and the enrollment team. (Note: Available hours of care are different at the ELC-Truax and the ELC-South centers).

Questions	Before Care	After Care	Before and After Care	All Day
Monday	Before Care	After Care	Before and After Care	All Day
Tuesday	Before Care	After Care	Before and After Care	All Day
Wednesday	Before Care	After Care	Before and After Care	All Day
Thursday	Before Care	After Care	Before and After Care	All Day
Friday	Before Care	After Care	Before and After Care	All Day

Child Information

Child 1 - Full Name

Child 1 - Date of Birth (or anticipated due date)

Child 2 - Full Name

Child 2 - Date of Birth (or anticipated due date)

Child 3 - Full Name

Child 3 - Date of Birth (or anticipated due date)

Comments

The Submit button is disabled due to your selection of Friday 4K services. The only allowable option is All Day (7:45-4:45). 4K services do not run on Fridays.