Family Child Care Business Start-up Worksheet

Note: This worksheet is not the license application. Rather, it is your first step on the road to licensure.

4C For Children has a contract with the State of Wisconsin to provide free assistance to help you obtain your child care license. The contract provides for a technical consultant from your local Child Care Resource and Referral to review a draft of the policy you develop, telephone and email support, and a visit to your site.

Please complete the information below.

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1. Contact Person (applicant): (Required.)

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2. Proposed family child care business name (optional):

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3. Address of child care program (Required.)

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4. County ~ Not finding your county? Please visit https://wisconsinearlychildhood.org/programs/pre-licensing/ (Required.)

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5. Phone number: (Required.)

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6. Alternate phone number:

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7. Best time to contact you between 8:00 a.m. and 5:00 p.m.:

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8. Email address that you check daily: (Required.)

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9. Type of family child care services you plan to offer (check all that apply): (Required.)

Full-day care

Part-day care

Before/after school care

School year only

Full year

Summer Only

Evening/Night

Weekend

Inclusion of children with special needs

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10. Groups you plan to serve (check all that apply): (Required.)

Infant/toddler (children under 2 years)

Preschool (children 2-4 years)

School-age (children 5-12 years)

Family Child Care Business Start-up Worksheet

Question Title

* 1. Contact Person (applicant): (Required.)

Question Title

* 2. Proposed family child care business name (optional):

Question Title

* 3. Address of child care program (Required.)

Question Title

* 4. County ~ Not finding your county? Please visit https://wisconsinearlychildhood.org/programs/pre-licensing/ (Required.)

Question Title

* 5. Phone number: (Required.)

Question Title

* 6. Alternate phone number:

Question Title

* 7. Best time to contact you between 8:00 a.m. and 5:00 p.m.:

Question Title

* 8. Email address that you check daily: (Required.)

Question Title

* 9. Type of family child care services you plan to offer (check all that apply): (Required.)

Question Title

* 10. Groups you plan to serve (check all that apply): (Required.)

1. Contact Person (applicant): (Required.)

2. Proposed family child care business name (optional):

3. Address of child care program (Required.)

4. County ~ Not finding your county? Please visit https://wisconsinearlychildhood.org/programs/pre-licensing/ (Required.)

5. Phone number: (Required.)

6. Alternate phone number:

7. Best time to contact you between 8:00 a.m. and 5:00 p.m.:

8. Email address that you check daily: (Required.)

9. Type of family child care services you plan to offer (check all that apply): (Required.)

10. Groups you plan to serve (check all that apply): (Required.)