2-Minute Anonymous Child Care Cost Survey
1.
Anonymous Survey
Survey for
1 child
.
If completing for multiple children, please fill out
1 survey per 1 child
*
1.
What is your child's age?
(Required.)
0-12 Months
1-2 Years
2-3 Years
3-4 Years
4-5 Years
5+ Years
*
2.
In what ZIP code is your child care located? (enter 5-digit ZIP code; for example, 00544 or 94305)
(Required.)
*
3.
What is the business name of the child care service that your child attends?
(Required.)
*
4.
What frequency of childcare is your child enrolled in?
(Required.)
Full time (5 days/week)
Part Time (3 days/week)
Part Time (2 days/week)
*
5.
At what frequency are you billed for childcare?
(Required.)
Daily
Weekly
Biweekly (every other week)
Bimonthly (twice a month)
Monthly
Other (please specify)
*
6.
What amount does your child care provider bill you for 'tuition' only? (per billing period you selected from Question 5; example, if you selected weekly, how much is your weekly payment)
(Required.)
*
7.
What amount are you billed annually for a 'registration' fee? (if not applicable or unsure, answer 0)
(Required.)
*
8.
What amount are you billed annually for a 'summer camp' or special activities fee? (if charge exists but your provider would not bill you for it currently based on your child's age, please answer 0)
(Required.)
*
9.
Does your child care facility provide any of the following
at no cost
to you? (check all that apply)
(Required.)
Diapers
Wipes
Breakfast
Formula
Lunch
None of the above
Other (please specify)