Non-Subsidized Child Care
Application For Child Care
Full-time program for children ages 3 months to 5 years old
(Please submit a separate application for each child)
Child
Child's First Name:
Child's Last Name:
Date Your Child Needs Care:  (mm/dd/yyyy)
Child's Gender:
Child's Date of Birth (Due Date):  (mm/dd/yyyy)
 
Name(s) of your other children currently enrolled at UCSD child care:
  First Name                        Last Name
Child 1:
Child 2:
Child 3:
 
Are you a single parent?
Are you eligible for a PELL grant?
 
Parent/Guardian 1
First Name:
Last Name:
Home Phone Number:
Work Phone Number:
Address:
City: State: Zip:
Email:
Employment Status:
UCSD Affiliation:
 
 
Note: Your waitlist application is not complete until your non-refundable application fee has been received by the administration office. The application fee for university staff, faculty, post docs, and community families is $70 per child. For UC San Diego undergraduate and graduate students the application fee is $35 per child. Submitting this application places your child on a waiting list pending receipt of your non-refundable application fee. Your child will be considered by the date of application as space becomes available. After submitting your online application, mail your check, payable to UC Regents, to the address below.
 
 
University of California
Early Childhood Education Center, MC 0962
9500 Gilman Drive
La Jolla, CA 92093-0962
 
Parents/Guardians are responsible for keeping contact information (email, phone number and address) current. If we cannot reach you, your child(ren) will be removed from the waiting list. To change your contact information, call our office at (858) 246-0900 or email dbetita@ucsd.edu for assistance.
 
If you would like to receive an e-mail confirmation, please enter your e-mail address here:
 
 
© , Regents of the University of California. All rights reserved