Family, Consumer, and Human Development

EVENTS CALENDAR

24May2013

Museum is Closed for Reconstruction

Due to a sidewalk reconstruction project by the…

25May2013

Death & Burial Practices from Around the World at the Museum of Anthropology

From cremations to burials at sea, each culture has its…

25May2013

Swaner EcoCenter: Saturday Climbing Wall

Climbing Wall Hours: Saturdays from 1-3 p.m. The Swaner…

29May2013

Swaner EcoCenter: Beaver - Nuisance or Restoration Partner?

Beaver – Nuisance or Restoration Partner?…

30May2013

Relaxation Workshop

Relaxation College can be a very stressful time to be a…

More events

Updating Information

If you have already applied and need to update information, please send an email to misty.balls@usu.edu.

Child Development Lab Application

Please fill out the information below. When this application is received, the child's name will be placed on the Child Development Laboratory Waiting Lists as indicated. We will accept 3/4 of each school group for each lab on the basis of the application date. We will accept the remaining 1/4 of each group based on other specific criteria (referrals from medical professionals, etc). Please keep in mind that many children have been on the wait lists since birth so the lists are VERY long.

*Required

Child's Information

*First Name:

*Last Name:

*Gender:

Boy Girl

*Date Of Birth:

*Current Age (Months):

*Current Age (Years):

Family's Information

*Mother's Name:

*Father's Name:

*Address:

*City:

*State:

*Zip:

Phone:

Cell Phone:

*Email:

Preferred Contact:

Mother's Business Address:

Mother's Business Phone:

Father's Business Address:

Father's Business Phone:

Emergency Contacts

Emergency Contact 1 Name:

Emergency Contact 1 Address:

Emergency Contact 1 Phone:

Emergency Contact 1 Relationship To Child:

Emergency Contact 2 Name:

Emergency Contact 2 Address:

Emergency Contact 2 Phone:

Emergency Contact 2 Relationship To Child:

Siblings

Sibling 1 Name:

Sibling 1 Age:

Sibling 2 Name:

Sibling 2 Age:

Sibling 3 Name:

Sibling 3 Age:

Sibling 4 Name:

Sibling 4 Age:

Sibling 5 Name:

Sibling 5 Age:

Sibling 6 Name:

Sibling 6 Age:

Which lab(s) would you like?

Check all age groups applicable:
(plan for the future)

Infant/Toddler (Entering Age: Newborn - 24 Months)
Two-Year-Old (Entering Age: 2 - 2 years 9 months)
Three-Year-Old (Entering age: 3 - 3 years 9 months)
Four/Five-Year-Old (4 years+, cannot be attending Kindergarten)
Summer Four/Five-Year-Old (Four years+, cannot be attending Kindergarten)