Sign Up

If you are the parent of a child (or children) 8 years old or younger, the Early Learning Lab would like to invite your family to participate in our child development studies. It's a fun and easy way to contribute to society.

Parent Information
Name*:
ZIP Code:
Home Phone:	( ) -
Cell Phone:	( ) -
E-mail*:
Where did you hear about the Early Learning Lab?
Language Information
Are there non-English languages spoken in your home?	No Yes
If yes, what language(s):
How much?	less than 10% 25% 50% (bilingual) 75% 100% (no English spoken at home)
Child #1
Name:
Birth Date:	/ /
Full Term (born after at least 37 weeks of gestation):	No Yes
Handedness:	Not yet known Right Left Ambidextrous
Child #2
Name:
Birth Date:	/ /
Full Term (born after at least 37 weeks of gestation):	No Yes
Handedness:	Not yet known Right Left Ambidextrous
Child #3
Name:
Birth Date:	/ /
Full Term (born after at least 37 weeks of gestation):	No Yes
Handedness:	Not yet known Right Left Ambidextrous
Child #4
Name:
Birth Date:	/ /
Full Term (born after at least 37 weeks of gestation):	No Yes
Handedness:	Not yet known Right Left Ambidextrous
Future Contact
Would you like for us to share your information with other N.U. labs studying learning and child development? Yes No

To help us fight spam, please type the following letters: gh8rm

(Required) Why?