EMERGENCY CHILDCARE SURVEY
URGENT RESPONSE NEEDED
We understand that we may have families who are required to work and in desperate need for childcare. If this is you, please complete this survey so we can determine if we are able to offer this service. Thank you.
OK
1.
What is your name?
2.
What is your contact number?
3.
How many children do you have that will need emergency childcare?
1
2
3
4
5
None
4.
What grade is child 1?
Preschool
Kindergarten/1st Grade
2nd Grade/3rd Grade
4th Grade/5th Grade
Middle School (6-8 Grade)
N/A
5.
What grade is child 2?
Preschool
Kindergarten/1st Grade
2nd Grade/3rd Grade
4th Grade/5th Grade
Middle School (6-8 Grade)
N/A
6.
What grade is child 3?
Preschool
Kindergarten/1st Grade
2nd Grade/3rd Grade
4th Grade/5th Grade
Middle School (6-8 Grade)
N/A
7.
What grade is child 4?
Preschool
Kindergarten/1st Grade
2nd Grade/3rd Grade
4th Grade/5th Grade
Middle School (6-8 Grade)
N/A
8.
What grade is child 5?
Preschool
Kindergarten/1st Grade
2nd Grade/3rd Grade
4th Grade/5th Grade
Middle School (6-8 Grade)
N/A
9.
For staffing purposes, please indicate which hours you are looking for (example: I need 6:00 am to 3:00 pm.)
10.
I am willing and able to pay $200/week for each child.
Yes
No
11.
Questions or comments.
Current Progress,
0 of 11 answered