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United Way of St. Joseph Technical Assistance Registration
1.
Your child care program information
Name
Company
Address
Address 2
City/Town
ZIP/Postal Code
Email Address
*
2.
County of Child Care Program
(Required.)
*
3.
Child Care Program DVN # (License Number)
(Required.)
*
4.
Licensure Status
(Required.)
License
License-Exempt
Registered Vendor
*
5.
Child Care Program Type
(Required.)
Center
Group Home
Family Child Care
Afterschool Program
*
6.
Which race/ethnicity best describes the program owner? (Choose only one.)
(Required.)
White/Caucasian
Black/African American
Hispanic/Latino
Asian/Asian American
American Indian/Alaska Native
Native Hawaiian/other Pacific Islander
Another race
*
7.
Which race/ethnicity best describes the program director? (Choose only one.)
(Required.)
White/Caucasian
Black/African American
Hispanic/Latino
Asian/Asian American
American Indian/Alaska Native
Native Hawaiian/other Pacific Islander
Another race
*
8.
What is the gender of the program owner?
(Required.)
Female
Male
Other (please specify)
*
9.
What is the gender of the program director?
(Required.)
Female
Male
Other (please specify)
*
10.
What is your child care program business status?
(Required.)
501c3 Non Profit/IRS Tax-Exempt
Corporation
Sole Proprietorship
Individual
Partnership
Other (please specify)
*
11.
Do you know the program's Missouri BUYS System ID Number
(Required.)
Yes
No
*
12.
What is the program capacity?
(Required.)
6 or Fewer
Up to 10
11-30
31-50
51-100
100+
*
13.
Does the child care program accept subsidy?
(Required.)
Yes
No
Other (please specify)
*
14.
What is your confidence level in writing for this grant before the technical assistance session?
(Required.)
Highly confident
Somewhat confident
Not confident
Not sure
*
15.
What level of confidence level in pursuing grant opportunities on your own before the technical assistance session?
(Required.)
Highly confident
Somewhat confident
Not confident
Not sure
*
16.
Which session(s) will you be attending?
(Required.)
Virtual pre-session on March 28th from 7p-8p
Face-to-face TA on April 2nd from 10a-4p
*
17.
What grant do you need assistance with?
(Required.)
Prerequisites of Grant Submission
Paycheck Protection Program
Child Care Technical & Business Assistance Grant
Start-up/Expansion/Enhancement Grant
Unsure what grant I'll be applying for.
Current Progress,
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