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Apply to Enroll

EL Auto Claiming - TEST 2 Director: El Autoclaim Provider 2 Test

Select a child to enroll, or add a new child. Enrollment must be completed for each child.

First Name *

Last Name *

Gender *

Date of Birth *

What is your desired schedule?

Schedule *

Days of week *

Drop off time *

Pick up time *

Monday

Tuesday

Wednesday

Thursday

Friday

Start Date *

Any comments regarding desired schedule?