Childcare Needs Assessment Survey for people who need childcare.

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* 1. Are you in need of childcare so you can return to work?

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* 2. How many children in your household would need childcare?

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* 3. What are the ages of children requiring childcare?

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* 4. What hours would you require daycare?

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* 5. What can you afford to pay for childcare?

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* 6. Would you like to receive information of persons who are considering offering childcare?

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* 7. If you wish to receive childcare information, please provide your contact information.  It will not be shared without your permission.

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