McComb Community Area Childcare Survey
We need your help to determine what childcare needs we have, so we can apply for grants to hopefully expand childcare opportunities.  Thanks very much!!
Sign in to Google to save your progress. Learn more

If you are interested in having your name be placed on a Waiting list in the event that we are successful in obtaining licensed daycare, please include your contact information below.

 Name

Email Address & Phone #

1.    Would you use licensed fulltime childcare services in McComb if they were available to you?   

*

2.    Would you use After &/or Before school childcare services in McComb if they were available to you?   

*

3. Please check the amount you consider reasonable to pay for daytime childcare (amounts are estimates only)    Per week for 1 child for   Full time (5 days per week)  

*

4.  Please check the amount you consider reasonable to pay for Daytime Care per week for 1 child  for  Part time        (2-3 days per week)                     

*

5. Please check the amount you consider reasonable to pay Per week for Before &/or After School Care   for 1 Child   

*

6. If there were full-time childcare services in McComb available to you, please add times you would need.

*

7. Please list the ages & number of children you would place in daycare if available.

 Number of children _________________     

Ages of Children _______________

Please answer in the space below:


*
8. Please mark all of the following problems you have experienced with daycare this year. *
Required
Next
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy