You may use this form to apply to Zimtor Family Child Care. On receipt of the application, I will schedule you for a parent interview and your child for a one-day classroom visit to Zimtor. You may observe your child’s visit but not participate. Following the interview and visit, I will either make an offer of admission or explain why your child is not eligible for admission.

Required fields are marked with an asterisk.

You may also download the form as a fillable PDF. Not all PDF readers support the fillable feature, but most do. Download Application (521 KB)


  • Is your child toilet trained?*

  • Other than Covid, will your child have all immunizations specified in the Centers for Disease Control schedule by the start date?*

First Parent

All school communication will be directed to the contact information in this section.

Second Parent