Exit Child Care Needs in NEA Question Title * 1. The total number of children in my household is… Not Born Yet or 1 2 3 4 5 More than 5 Question Title * 2. My youngest child is… Not born yet Infant Toddler Pre-K Elementary Question Title * 3. I currently have child care that meets my needs for employment hours. Yes Sometimes No Making a plan for future Question Title * 4. My arrival to work most closely resembles… Clock-in earlier than 5:30am Clock-in near 6:00am Clock-in near 6:30am Clock-in near 7am Clock-in near 7:30am Clock in near 8am Clock in near 1pm Clock in near 2pm Clock in after 10pm Question Title * 5. My time leaving work mostly resembles…. Between 2pm and 3pm Between 3pm and 5pm Between 530pm and 6pm Between 6pm and 6:30pm Between 7pm and 8pm Between 8pm and 9pm Between 10pm and 12am Between 1am and 6am Question Title * 6. List 1-2 towns which are most convenient for your child care needs. Question Title * 7. I prefer child care to be… Babysitter or Nanny or Un-licensed In-Home Licensed In-Home Licensed Child Care Center No preference Question Title * 8. Do you have back-up child care options for children under age 5? Yes Sometimes No Does not apply to me Question Title * 9. Do you have back-up child care options for children over age 5? Yes Sometimes No Does not apply to me Question Title * 10. My household size qualifies for Arkansas childcare assistance based on income and employment.The Sliding Scale is available on the Arkansas DHS website. Unsure Yes No Question Title * 11. I am familiar with the term ‘Better Beginnings’ and what it means in relation to licensed child care providers. Yes Somewhat No Question Title * 12. I would like to be contacted to discuss child care options. Provide name and phone number below. Done