Thanks for your interest! Please complete this form. You can expect a response from us within two business days.

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* 1. Select the county where the program will be located:

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* 2. What type of license program are you pursuing: family child care or adult foster care?

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* 3. If you are interested in an adult foster care license, do you plan to pursue a 245d license as well?

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* 4. Have you been licensed before?

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* 5. Do you need interpreter services?

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* 6. Do you have any Hispanic heritage?
The county licensing system we use requires this information, it's part of its audit requirement.

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* 7. Full name:

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* 8. Phone number:

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* 9. Email:

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* 10. What question(s) do you have about becoming a licensed provider?

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