CDC Waiting List

Thank you for your interest in the St. John's CDC! Please fill out and submit the form below.

Child's Name*
First Last
Date of Birth*
MM slash DD slash YYYY
Parent's Name*
First Last
Phone*
Email*
Payment*
- Private Pay
- DSS Voucher (subsidy)
Requested Date of Enrollment*
MM slash DD slash YYYY

Questions?

Contact us at
704-636-6756 phone
704-633-1299 fax
cdc@stjohns-salisbury.org