Inquiry Form
Please complete the form below and click submit.
Enter your Information:
First Name
*
Last Name
*
Relationship
*
- Select One -
Mother
Father
Grandmother
Grandfather
Guardian
Joint Custody
Other
Email
*
Phone
*
Child Information
First Name
*
Last Name
*
Date of Birth
*
Gender
*
Select One
Male
Female
Other
Unknown
Requested Start Date
*
Add Additional Child
Location Information
KidHub
2 Nevin Lane
Cornwall, PE
C0A 1H0
902-388-5437
Referral / Comments
How did you hear about us?
*
- Select One -
Referral from Another Parent
Referral from a Staff Member
Referral from Family or Friend
Facebook
Instagram
Online Search
PEI Child Care Registry
Other
Comment
Submit
Reset