Please be advised we are currently experiencing intermittent phone issues at the Bishop Campus. If you cannot reach us on the direct Bishop line, please call 760-384-6199. We apologize for the inconvenience and hope to have the issue corrected soon.

Cerro Coso Community College

Child Development Center Application Form

Preliminary Application

Please fill out all of the following information.

Parent/Guardian Information
Parent/Guardian A
Parent/Guardian B
Physical Address and Phone for Parent/Guardian living with Child
Child and Family Information
Please list ALL the children in the family.
Child #1
Child #2
Child #3
More Parent/Guardian Information
Needed only if parent/guardian is living with the child
Parent/Guardian A
Please check all that apply
Gross Monthly Income
$
$
$
$
$
$
$
$
$
Parent/Guardian B
Please check all that apply
Gross Monthly Income
$
$
$
$
$
$
$
$
$
Kern Community College District