Directory Results for THERESE EARLY EDUCATION CENTER 20142015 Confidential Health Ination Childs Name: Date of Birth: Childs Pediatrician: Phone: Official documentation (photocopy of childs immunization record) noting that the child is current on - - - - - - to THERESE EARLY EDUCATION CENTER Wait List Ination I am interested in placing my child on the wait list for the 20132014 school year Current Date Requested Start Date Child 's Name Last First Middle Gender Date of Birth or Due Date - - -