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* 1. Your child care program information

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* 2. County of Child Care Program

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* 3. Child Care Program DVN # (License Number)

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* 4. Licensure Status

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* 5. Child Care Program Type

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* 6. Which race/ethnicity best describes the program owner? (Choose only one.)

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* 7. Which race/ethnicity best describes the program director? (Choose only one.)

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* 8. What is the gender of the program owner?

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* 9. What is the gender of the program director?

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* 10. What is your child care program business status?

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* 11. Do you know the program's Missouri BUYS System ID Number

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* 12. What is the program capacity?

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* 13. Does the child care program accept subsidy?

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* 14. What is your confidence level in writing for this grant before the technical assistance session?

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* 15. What level of confidence level in pursuing grant opportunities on your own before the technical assistance session?

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* 16. Which session(s) will you be attending?

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* 17. What grant do you need assistance with?

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