Thank you for your interest in participation!

Please fill out the form below and we'll enter you into our database. You can also call us at (213) 740-2936.

When your child approaches the right age for one of our studies, we will contact you with more information. Each study is short, lasting between 5 and 15 minutes. When you come, you can expect to be at the lab 20-30 minutes. Many studies require just one visit; some of the studies request one or two follow-up visits.

We will provide a parking pass for you, and as a token of appreciation we have a T-shirt for your child, which reads "Graduate of the University of Southern California Language Development Lab."

Please be assured that information you send us is kept confidential, will not be disclosed to any other party, and will only be used to advise you about our studies.

Thank you!

Parent(s) name(s):

Child's name:

Child's date of birth: January February March April May June July August September October November December 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 2009 2010 2011 2012

Telephone contact number:

Email address :

Zip Code :

How did you hear about us? From a friend Received a mailer The Santa Monica Mirror The Daisy Chain e-newsletter UCLA Baby Lab Other (please describe below)

Comments:If you have more than one eligible child, please enter information here, plus any other comments or questions.