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First Baptist Church of Clarendon Child Development Center Waitlist Form 1306 N. Highland Street Arlington VA 22201 Phone 703 522 6477 Fax 703 522 7142 Today s Date Child s Name Child s Date of Birth estimated if expecting Parent s Name s Address Contact Information please the best number to contact Home Phone Mom s Cell Phone Dad s Cell Phone Mom s Business Phone Dad s Business Phone Desired Enrollment Date The requested date is not guaranteed. Each child will remain on our waiting list...
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