Please complete the following information. Required fields are marked with an asterisk (*).
Evening(s) childcare will be needed:
The remainder of the fee should be paid at the time you drop off your child. For that remainder, forms of payment we accept are: Cash, Check, or Money Order made out to the Trustees of the University of Pennsylvania. Please note that we cannot accept credit card payments on site at the Childrens Center.
Please check your information carefully for accuracy, and then click "Submit." An email confirmation will be sent to the email address entered above.