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Membership Inquiry Form

If you send in this form, you will automatically be placed on our waiting list. If there is an opening for your child, we will contact you by telephone. Please update your status every 6 months to confirm your interest in staying on the waiting list. If we have not heard from you, your name will be removed.

Parents' names:
Phone:
E-mail:
Mailing address:
Child's name:
Child's age:
Child's birthdate:


How did you hear about us?
Why are you interested in a cooperative vs. a childcare or preschool situation?
Has your child been in other childcare situations?
Have you ever been a member of a cooperative?


Do you have any questions about the Eastside Family Cooperative?


Requested start date:

© 2007 Eastside Family Cooperative • Portland, OR