Googols of Learning
500 Rockledge Road
Lawrence, KS 66049
Email: admin@googolsoflearning.com
Phone: 785-856-6002
If you do not receive a response from this form email within 24 hours, please call us directly at 785-856-6002
Complete Application Packet
CLICK HERE to download a PDF version.Preschool Enrollment Form
Required for on-going child care only. Both State of Kansas forms are required as well. Note: This does not guarantee enrollment. You may be placed on a waiting list. Please contact the Program Director if you require additional information. CLICK HERE to download a PDF version.
Child Questionnaire
Please help us get to know your child by filling out this form. All the information will be confidential. Your child’s teacher will use what you tell us as a way to begin to get to know your child and your family and so he or she can plan ways to meet your child’s needs. It is also important to us to know what you want your child to learn in his or her class, so please answer question # 21 carefully. Please return it to school as soon as possible. CLICK HERE to download a PDF version.
Medical Record Form
Required for all child care. The Child Health Assessment Form (Page 1) must be signed by a physician. If your child has had a checkup within the last 6 months, your doctor's office may provide us with the form based on the most recent appointment. The Immunization Record (Page 2) may also be provided by your doctor's office. They may fax both pages to us at 785-856-6003. CLICK HERE to download a PDF version.
Authorization for Emergency Medical Care Form (State of Kansas)
Required for all child care. This form must be notarized. Googols generally has a notary on-site on Mon-Thurs from 9 AM to 5 PM. We recommend that you call first to confirm availability. CLICK HERE to download a PDF version.
Immunization Information Sheet
To prevent disease outbreaks in a community, the immunity threshold requires 85%-95% of the population be vaccinated, depending on the disease. When parents choose not to vaccinate, they put their children, and our community, at greater risk of severe, vaccine preventable diseases. At Googols, we are concerned not just for the other immunized children in the building but adults that may be immuno-compromised, pregnant women, or young infants that have not yet had their full series of vaccines. As of June 1, 2017, we have made a policy decision to no longer enroll children that are unimmunized for reasons of religious or personal belief. Children on a 'catch-up' schedule will be accepted with official documentation from a licensed physician.
CLICK HERE to download.
Allergy Care Form
If your child has moderate to severe allergies requiring medication such as antihistamines, rescue inhalers, or epi-pens, we require an Allergy Care Plan be completed. Please print and complete the form below with consultation from your child's doctor. The form requires a signature from the physician or health care practitioner. CLICK HERE to download the form.
Short-Term Medication Form (State of Kansas)
Required only if you are providing prescription OR non-prescription medication to be administered temporarily or occasionally, while in our care. All medications must be in the original packaging and labeled with the child's name. All prescription meds must also have a label with Doctor's name, dosage, and expiration date. Do not bring expired medications of any kind. CLICK HERE to download a PDF version.
Long-Term Medication Form (State of Kansas)
Required only if you are providing prescription OR non-prescription medication to be administered on a constant, daily, or regular basis, while in our care. All medications must be in the original packaging and labeled with the child's name. All prescription meds must also have a label with Doctor's name, dosage, and expiration date. Do not bring expired medications of any kind. CLICK HERE to download a PDF version.
