
Contact you DTA worker to obtain a Child Care Referral. You or your DTA worker should fax the referral to Child Care Circuit.
Lawrence - 978.975.3120
Beverly - 978.927.8083
You will need a child care provider before emailing this. If
you need assistance in finding a provider, visit our website
www.childcarecircuit.org
and select the parent screen.
Once you have chosen the provider and faxed the referral to Child Care Circuit please complete the information below.
Your Case Manager at Child Care Circuit will contact you by email or phone to give you a time to come in and sign voucher. The voucher will not be effective until after the voucher is signed.
Please complete the following information before submitting this form:
USE THE TAB KEY TO GO BETWEEN ENTRIES.
DO NOT HIT RETURN UNTIL ALL INFORMATION IS FILLED OUT.
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E-Mail:
info@childcarecircuit.org
Beverly Office: 180 Cabot St., Beverly, MA 01915
Phone: (800) 660-2868 · Fax: (978) 927-8083
Lawrence Office: 190 Hampshire St., Lawrence, MA 01840
Phone:
(877) 823-2273 Fax: (978) 975-3120
Office Hours: Monday 9 AM - 7 PM, Tuesday - Friday 9 AM - 5 PM