Application

Should you be interested in becoming a provider, please complete and
submit the online application form below.

Once your application has been processed, the Program Consultant will
make an appointment to meet with you in your home.

Home Visit

During the home visit the Consultant will answer any questions you may
have and go over program requirements in the areas of safety and appropriate
activities. Once these requirements have been met, you are to contact the
Day Home office and the Consultant will return to ensure that Program require-
ments have been fulfilled. At this time, a contract will be entered into in which
you are self employed and contracted to our Program.

Should you join our child care team, we are certain you will find it to be an interesting and rewarding experience.

Application Form:

* Required fields * First Name * Last Name * Phone * E-mail Address Street Address Community What type of home do you live in? Please select House Townhouse Apartment Duplex Fourplex Non-smoking house? Yes No Do you have a yard? Yes No Is your yard fenced? Yes No Do you have pets? Yes No   Languages spoken (other than English)?   Days available?   Hours available?   When would you like to start your dayhome?   Previous child care experience?   What makes you interested in becoming a Dayhome Provider?   What ages of children would you prefer to care for?   How many children would you prefer to care for?   Can you give some examples of activities you can do   with the children?   What play/child care equipment do you have?   Are you willing to transport children?   Do you have children of your own? Please provide their   age and gender.   Are you presently caring for children other than your own?   How would you rate your home for cleanliness on a scale of 1-10?   Have you ever been with another Dayhome Agency?   How did you hear about us?   Do you have any comments or questions?  Please enter the security code you see below:

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