REGISTRATION DOCUMENTS

Christian Pentecostal After School & Full Day Child Care Services

613-615 Nye Ave, Irvington, NJ 07111 | Telephone: (973) 399-0004 | Fax: (973) 399-3331

Divine Direction Learning Center

219 Orange Ave, Irvington, NJ 07111 | Telephone: (862)955-3452

Christian Pentecostal After School

1442 Springfield Ave. Irvington, NJ 07111 | Telephone: (973) 375-0605

Deborah F. Simpkins, Executive Director

The following list of documents are required for your child(ren) to be enrolled at Christian Pentecostal After School/Full Day facilities:

  • Enrollment Information COMPLETE HERE

  • Medical Emergency Release/Treatment Form COMPLETE HERE

  • Authorization to Pick-Up Child COMPLETE HERE

  • Infant Notification Letter (0 - 12 months of age) COMPLETE HERE

  • Child and Adult Care Food Program ELIGIBILITY APPLICATION (Meal Form) COMPLETE HERE

  • Transportation Agreement (if transportation is required) COMPLETE HERE

  • Universal Health Record (Must Be Completed and Signed by Doctor or Clinic PRIOR TO start date) MUST UPLOAD BELOW

  • Immunization Record including Flu Shot vaccination (prior to start date) MUST UPLOAD BELOW

  • Copy of Birth Certificate or document validating that students) is/are qualified residents. MUST UPLOAD BELOW

  • Copy of child(ren)'s Social Security Card MUST UPLOAD BELOW

Items required for the 1st day of school:

Infants & Toddlers:

Diapers/Pull-Ups - 1 full package (you will be notified when supply is low)

1 box of baby wipes - at least 80 - 100 count

Any cream, powder, mylicon etc. that you wish to use

2 changes of clothing (t-shirt, sleeper, outfit and socks)

Careful attention should be made to maintain current sizes left at school!

Return a full-set when a soiled set is sent home!

2 Blankets or 1 sheet and 1 Blanket

Preschoolers:

Change of Clothes (complete set including underwear and socks)

1 Sheet and Blanket

Proper outerwear for outside play and walks.