Demographics

Dear Child Care Professional,

Thank you for considering extra or alternative employment while many child care programs are closed due to the COVID-19 outbreak.  Our primary goal is to help child care programs to operate so that families with on-going child care need can continue to work.

This brief survey will be used to identify individuals who can readily begin work in other child care programs.  By completing this survey, you acknowledge that the information you provide, including your contact information may be shared with child care programs who are in need of additional staff. Completion of this survey does not guarantee you employment with another child care provider and is not meant to encourage staff to work for other programs indefinitely. Rather, it is intended to help match child care professionals who want to continue working with programs that have short term needs for staff.

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* 1. First Name

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* 2. Last Name

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* 3. Date of Birth

Date

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* 4. Phone number (Please leave dashes out)

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* 5. Email Address

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* 7. What zipcode do you live in? (Five Digit Format)

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