Enrollment Application

To complete the Application Form: open the form by double-clicking on the image below. If you are on a smartphone, you can then view, download and/or print the form. If you are on a PC or tablet, you may need to click on the square icon with the arrow that appears in the upper left of the form that reads "Open in new tab" when you move the mouse pointer over the icon. This will open the document to view, download, complete and email to:

info@indianolachildrenscenter.org

or you can print and complete the form and mail us a paper copy to: