Waiting List

University Child Care Center is open to everyone in the community. Please complete the following form to add your child to the waiting list for the University Child Care Center.

Parent's Name:

Phone Number:

Child's Name:

Child's Birth Date:

Semester and Year Child Needs to Begin at UCCC:

Please mark if you are:
  Student at Missouri State or another college
  Missouri State staff
  Missouri State faculty
  Member of South Street Christian Church
  Community Member

What type of care do you need?
  Full-time
  Part-time

What type of child care schedule do you need?
  Full year
  Academic year

How did you hear about University Child Care Center?