Convenient location to I-10
5315 E. 5th Street, Katy, TX 77493

Please call for more information and to schedule a visit!
(281) 391-8750

Steve Sandweiss – Owner
Jane Toevs – Director
Cheryl Myers – Asst. Director

INFORMATION REQUEST FORM

First Name:

Last Name:

Email:

Home Phone:

Street Address:

Work Phone:

City:

Fax:

State/Province:

Postal Code:

Country:

Number of children needing care:

Languages spoken by child(ren):

English Only
Spanish Only
Bilingual
Other

Birth Dates of Children:

First Child:

Second Child:

Third Child:

Please check the areas that you are inquiring about. You may also use the space below to specify areas not listed or pose a question.

Areas of Interest:

Infant Program	Toddlers & Pre-School
Before & After School Care	Private School(Pre-K through 2nd Grade)
Summer Camp
Type questions here...

Preferred method of contact:

Phone
Email
Address

How did you learn about us?

Drive by
Katy Magazine
Katy Christine Magazine
Referral
Direct Mail
Google
Yahoo
yellowpages.com
Other

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