LOCATE: Child Care Johns Hopkins Registration Form

If you are looking for backup care only, please contact Johns Hopkins Benefits & Worklife at
410-516-2000.

TO RECEIVE LICENSED CHILD CARE REFERRALS, PLEASE COMPLETE THIS REGISTRATION FORM, THEN CHOOSE ONE OF THE OPTIONS BELOW. MAKE SURE TO CLICK "DONE" TO SUBMIT THE FORM.

#1. If you would like a Specialist to contact child care providers on your behalf to look for openings, an appointment for a phone intake will be scheduled based on availability and the times you provide. You will receive an appointment confirmation; please watch for email and check spam/junk, if necessary.

#2. If you prefer not to wait for an appointment or need child care immediately, you may complete an online intake to receive a list of child care providers with unconfirmed openings and program information. See link at the end of this form. Please watch for email and check spam/junk, if necessary.

#3. You may do your own web search in the LOCATE: Child Care database. See link at the end of this form. For log-in, please enter the same email address used for all other LOCATE communications.

Question Title

* 1. Parent First Name

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* 2. Parent Last Name

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* 3. Street Address

Address

City/Town

State/Province

ZIP/Postal Code

Email Address

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* 4. Best Daytime phone number

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* 5. JHED ID

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* 6. Johns Hopkins Affiliation: Which institution are you employed by?

JHU

JHH/JHHS

JHHC/JHCP/JHHCG

BMC

Other (please specify)

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* 7. IF JHU, is your division the School of Medicine?

Yes

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* 8. What is your affiliation? (Required)

Staff or Employee

Faculty

Postdoctoral Fellow, Resident/Intern/House staff, Doctoral or Medical Student

Graduate or Undergraduate Student

Future Affiliate: If you are accepting a position/appointment or enrolling with Hopkins, please provide documentation by emailing a copy of your acceptance letter to confirm eligibility. Please black out your salary information and email to locatecorporate@marylandfamilynetwork.org

Other (please specify)

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* 9. How did you hear about LOCATE?

Benefits

Co-Worker

Internet

Other (please specify)

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* 10. Child 1

Name

Age

Date of Birth

Date Care Needed

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* 11. Child 2

Name

Age

Date of Birth

Date Care Needed

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* 12. Child 3

Name

Age

Date of Birth

Date Care Needed

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* 13. Child 4

Name

Age

Date of Birth

Date Care Needed

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* 14. Schedule a telephone appointment to talk about your child care needs and to initiate a customized child care search. Using the scheduling chart, please choose a time each day when you can be available.

	Time
Monday	Monday Time menu
Wednesday	Wednesday Time menu
Thursday	Thursday Time menu

Once your registration form is received, a representative of LOCATE Corporate Enhanced Referral Service will review appointment availability, schedule your phone intake, and email a confirmation. If you don't hear from us within 2 business days, please check your spam/junk folder. We will schedule for the next available appointment in one of your time slots. Appointments are scheduled on a first come, first served basis and may be scheduled several weeks out. The LOCATE Referral Specialist will call you at the scheduled time on the daytime number you provided.

LOCATE: Child Care Johns Hopkins Registration Form

Question Title

* 1. Parent First Name

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* 2. Parent Last Name

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* 3. Street Address

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* 4. Best Daytime phone number

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* 5. JHED ID

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* 6. Johns Hopkins Affiliation: Which institution are you employed by?

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* 7. IF JHU, is your division the School of Medicine?

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* 8. What is your affiliation? (Required)

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* 9. How did you hear about LOCATE?

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* 10. Child 1

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* 11. Child 2

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* 12. Child 3

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* 13. Child 4

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* 14. Schedule a telephone appointment to talk about your child care needs and to initiate a customized child care search. Using the scheduling chart, please choose a time each day when you can be available.

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* 15. Comments