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Why Choose C5?

Application for Enrollment
Your Full Name:*

(person submitting; first parent / guardian)
Relationship to Child
Your Email Address:*
Alternate Email Address:
Home Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone Number:*
Alternate Phone Number:
Child's First Name:*
Child's Last Name:*
Child's Date of Birth, Due Date, or Approximate Due Date*
MM slash DD slash YYYY
Sex of Child*
Desired Enroll Date:*
MM slash DD slash YYYY

Note: This application is viable for one year and must be renewed annually to maintain consideration.
Number of Siblings
Your Employer*
Select if Employer is Listed
Note: Government employment is verified before enrollment.
Employment Industry
Your Position
Your Work Number
Additional Information
For second parent / guardian (if applicable)
NOTE – Please complete all fields required* below. Thank you.
Partner's Full Name
Partner's Relationship to Child
Partner's Email Address
Partner's Alternate Email Address
Partner's Phone Number
Partner's Employer
How did you become aware of and learn about us?
Referral Source*
Referral Code, if You Have One
Does your family have an Early Learning for All (ELFA) subsidy from the City of San Francisco?
- Yes
- No
Once this form is complete, click Submit to proceed to payment of the application fee.