Thank you for your interest in the Edu-Childcare program at Lehigh Valley Children's Centers (LVCC). Please fill out the information in full so we can best serve your needs.

A representative from LVCC will contact you within three business days.

Parent or Guardian's Name *

Phone Number *

Email Address *

How many children in your household (ages 5-12) will need Edu-Childcare? *

Child #1 *

Child #2

Child #3

Child #4

Child #5

Child #6

What grade will your children enter as of August 2020? *

Does your child currently attend a before- and/or after-school child care program operated by Lehigh Valley Children’s Centers? *

Do you need child care when school is not in session? *

If you are in need of child care, which LVCC location would be most suitable to you? *

Can LVCC support your needs and refer your name to other community agencies providing Edu-Childcare? *