Thank you for your interest in becoming part of the TCLC family! Please fill out the following application completely and accurately. ALL INFORMATION IS KEPT CONFIDENTIAL. Please call us with any questions 541-475-3628.
Click here to find a provider in your area.

Are there other adults in the household?

Add Another Adult

Do you want to apply now for another child in your family?

Add Another Applicant

Are there other children in the family?

Add a Sibling
Thank you for submitting your application. We will process the information and contact you soon with further instructions. If you do not receive a response within 3 business days, please call 541-475-3628. By submitting this online application I certify that the information on this application, including financial if included, is to the best of my knowledge, true and correct. I authorize TCLC to access my child's immunization records using the Oregon Alert System if they are accepted to attend.
Required information is missing, see above.