Government Forms

The following forms (our application and government forms) must be filled out in order for your child to attend Jems preschool, along with a current copy of your childs immunization records.

LIC 613A (04/99)

PERSONAL RIGHTS- CHILD CARE FACILITIES

LIC 627 (05/01)

CONSENT FOR EMERGENCY MEDICAL TREATMENT- CHILD CARE CENTERS OR FAMILY CHILD CARE HOMES

LIC 700 (05/00)

IDENTIFICATION AND EMERGENCY INFORMATION CHILD CARE CENTERS

LIC 701 (08/01)

PHYSICIAN'S REPORT - CHILD CARE CENTERS (CHILD'S PRE-ADMISSION HEALTH
EVALUATION)

LIC 702 (07/99)

CHILD'S PREADMISSION HEALTH HISTORY PARENT'S REPORT

LIC 995 (08/02)

CHILD CARE CENTER - NOTIFICATION OF PARENTS' RIGHTS