Early Learning Application

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

Name

Company

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Email Address

Phone Number

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* 2. Business Contact Information

Company

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Country

Email Address

Phone Number

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* 3. Type of Organization

Non-Profit

LLC or other For-Profit Corporation

Sole Proprietor

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* 4. What Industry are you in?

Early Learning Child Care Center

Early Learning Home Care Provider

Adolescent Group Home

Misc. Non Profit Business Owner

Misc. For Profit Business Owner

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

8 am - 2 pm

3 pm - 8 pm

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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?

20 - 30

31 - 50

51 or more

N/A

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* 9. What is your current enrollment?

20 - 30

31 - 50

51 or more

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

1 Star

2 Star

3 Star

4 Star

5 Star

N/A

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

Yes

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* 12. Current or Proposed Child Care Licensure Agency Administrator

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* 13. Total Projected Revenue for Last Year?

$10,000.00 - $49,900.00

$50,000.00 - $100,000.00

$100,000.00 - $250,000.00

$250,000.00 - $500,000.00

More than $500,000.00

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* 14. Total Projected Revenue for this Year?

$10,000.00 - $50,000.00

$50,000.00 - $150,000.00

$150,000.00 - $500,000.00

More than $500,000.00

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* 15. Select what services you are interested in.

Initial Consultation: $85.00/hr. consultation fee.

Basic Membership: (Lobbying/Advocacy/Networking/Access to Training, workshops and events.) (Minimum $150.00/Month) (Step up To Quality Rating of 3 or higher to qualify for Basic Membership)

Contractual Member: Short term contract. Services usually provided at an hourly rate with a pre-determined allotment of hours delegated per month. (Minimum 10 hours/month)(Fees range from $65 per hour/Prior to opening or $85 for centers currently operating)

Coalition Partner: 6-12 month contract for an array of services or project based. Services at this level are designed around increasing organizational capacity, compliance, administrative support and sustainability through growth, leadership and business development. Typical monthly rate ranges between $850.00 - $2,500.00 per month. Contract based on scope of work , agency budget and average daily enrollment.

Associate Partner: 12-36 month contract. The highest level of membership. AP's are provided on-site administrative support, access to capital funding, business cash flow services and other technical support to promote growth and sustainability. Typical monthly rate ranges between $1,300.00 - $2,500.00 per month. Contract based on scope of work , agency budget and average enrollment.

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* 16. Additional Services

Business Consulting Services: Business Planning, Strategic Planning, Business Sustainability through growth, capital lending, grant writing, financing and fiscal management. Fees are project based and may include a referral/access fee for service based upon services provided.

Personal and Professional Coaching: Personal growth strategies, workshops, 30/60/90 Action Plans, motivational workshops and presentations. Fees: $75.00 per hour based upon scope of work and agreement.

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

0 - 3 Years

4 - 10 Years

More than 10 Years

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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.

Absolutely

More than likely

Not sure

Early Learning Application

New Member Application

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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.