BCITSA Child Care Waitlist Form
Today’s Date: ________________ Primary Guardian Name: ____________________________ University Affiliation: Student ID# _________________
Staff ID# ____________________
Faculty ID# _________________ Phone No. Home: ________________________
Work: _____________________________
Cell Phone No.: __________________________
Email: ______________________________
Address: ________________________________________________________________ **We will send all updates through the primary email address*** Secondary Guardian Name: ____________________________ University Affiliation: Student ID# _________________
Staff ID# ____________________
Faculty ID# _________________ Phone No. Home: ________________________
Work: _____________________________
Cell Phone No.: __________________________
Email: ______________________________
Address: ________________________________________________________________ Child’s Name: ________________________________ Birth Date(YY/MM/DD): ____________________ Sex (please circle): M F
Age: _____________
Please send the Waiting list forms thru email or fax Fax: 604-434-3809 Email: uconnect@bcitsa.ca