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New Member Application

Please compete the following form to be considered for membership to the Early Learning Coalition.  Following the completion of this form, a member of TELC will review your application and notify you if you are approved for membership. 

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* 1. Personal Contact Information

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* 2. Business Contact Information 

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* 3. Type of Organization

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* 4. What Industry are you in?

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* 5. What is the best time to contact you? 

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* 6. During the selected time frame what is the best method? (Enter Email or Phone Number)

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* 7. Organization Website

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* 8. What is your licensed capacity?

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* 9. What is your current enrollment?

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* 10. What is your Step Up To Quality Rating?

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* 11. Were you referred by a current member of the Coalition? 

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* 12. Current or Proposed Child Care Licensure Agency Administrator

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* 13. Total Projected Revenue for Last Year?

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* 14. Total Projected Revenue for this Year?

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* 15. Select what services you are interested in.

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* 16. Additional Services

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* 17. How many years have you been in business? 

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* 18. If you were able to partner with a foundation or funding source that would share the expense for services up to 70% would you contract for 12 months on a trial basis.

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* 19. Please provide a brief narrative/summary of why you would like to own or manage a home based or Early Learning Child Care Center. 

0 of 19 answered
 

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