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Admission Application

Childcare Program Needed

Intended Start Date * required

How many children need care?

Please select all that apply:

I have one infant child under the age of 2

I have more than one infant child under the age of 2

I have no infants

I have 0-2 children under the age of 5

I have more than one child that is over the age of 5 and under the age of 13

Do you have approved childcare assistance? *

Yes, I have a CCDF childcare voucher for Indiana or Illinois

Yes, I have been approved for the Early Head Start Program

I am currently waitlisted for childcare vouchers

I don't know how to apply for childcare assistance and need help!

Please discribe your overall childcare needs. (i.e. children need pickups from school, overnight care, etc.)

Thanks for submitting!

In Between Time Academy

2273 Taney Pl, Gary, IN 46404

219-200-9946

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