1.

Please list your current contact information below.

Question Title

* 1. Please list your current contact information below.

Licensing information (You can refer to you EEC license to find this information) If your program is excempt simply type excempt in the program number field.

Question Title

* 2. Licensing information (You can refer to you EEC license to find this information) If your program is excempt simply type excempt in the program number field.

Please complete the information below regarding ages of children and current vacancies.

Question Title

* 3. Please complete the information below regarding ages of children and current vacancies.

What are your days and hours of operation?

Question Title

* 4. What are your days and hours of operation?

What do you charge families? Please enter your rate information by age group

Question Title

* 5. What do you charge families? Please enter your rate information by age group

Please select all that apply to you childcare program environment.

Question Title

* 6. Please select all that apply to you childcare program environment.

What type(s) of financial assistance do you accept? (Please check all that apply)

Question Title

* 7. What type(s) of financial assistance do you accept? (Please check all that apply)

Do you have experience and / or training in any of the following special needs? Please check all that apply.

Question Title

* 8. Do you have experience and / or training in any of the following special needs? Please check all that apply.

Please describe your program and/or what type of activities you offer the children? (This is shown on the profile of your program given to parents.)

Question Title

* 9. Please describe your program and/or what type of activities you offer the children? (This is shown on the profile of your program given to parents.)

What QRIS level is your program at?

Question Title

* 10. What QRIS level is your program at?

T