* Required

(Check One)​

How many children are you licensed to provide care for? (This number is on your EEC license.)

Group Sizes:

Child: Adult Ratio (EX. 3:1 Infants)

How many full time openings? (Monday-Friday, full days)
Note: Total FT openings should not exceed your licensed capacity minus your current FT children in care unless you operate multiple child care shifts.

How many part time openings?

What are your full time rates? (Please indicate per week, per day, or per hour)

What are your part time rates? (leave blank if you do not provide part time care)

(check as many as apply)​​​

What ages of children do you enroll in your program? (Ex: 1 month to 12 years)

(check all that apply)​​​​
(for more information on becoming a voucher provider, contact the Child Care Circuit at info@childcarecircuit.org)​​