Phone

714-965-2324

Email

info@childrenslearningconnection.com

Office Hours

Mon 08:00 AM – 5:00 PM

Tue 08:00 AM – 5:00 PM

Wed 08:00 AM – 5:00 PM

Thu 08:00 AM – 5:00 PM

Fri 08:00 AM – 5:00 PM

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Parent/Guardian First Name*

Parent/Guardian Last Name*

Parent/Guardian Home Phone*


Child Information*






Child DOB*

Diagnosis*


Primary Language*