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* 1. What is your zip code?

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* 2. How many children are in your household? Indicate # of children in each age range.

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* 3. What is your relationship to the children in your household? (Select all that apply)

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* 4. What is your family composition?

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* 5. What is your employment status (if more than one parent/guardian, please indicate employment for each)?

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* 6. Do you and/or a parent/guardian work between the hours of 5 pm and 6 am?

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* 7. Please indicate the reasons why you chose your specific child care arrangements. (Select all that apply)

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* 8. What type of care are you using/did you use for your child? (Check all you have used in the last 2 years)

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* 9. What would be your first and best choice of care for your children?

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* 10. Do you agree that high quality early literacy/learning for children ages 0-5 leads to better quality of life outcomes (better health, high school graduation, college graduation)?

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* 11. Please share your experience in seeking child care or early childhood education services or programs in our area.

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* 12. To help us obtain an accurate idea of the cost of child care, how much do you currently pay for child care (PER DAY PER CHILD)?

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* 13. How many days per week do you use child care?

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* 14. What is your annual household income?

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* 15. Would you be willing to talk more?

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