Essential Personnel Child Care Survey - Greenport Schools
The Greenport UFSD in cooperation with the Town of Southold is taking a survey to determine the child care needs of our community.  The district is exploring options with various child care providers to develop a plan that fits the needs of our community.

There will be no registration fees.  

Bagged meals will be available for children aged 5 to age 18 but students may also opt to bring food from home. Parents must provide specialized food when needed.

Keep in mind, this is a general survey to determine interest and the number of staff needed to run the program.

Please complete this survey no later than Wednesday, March 25 at 12 pm (noon).

Please complete this form if you are an essential employee defined by one of the 7 groups below and you are in need of child care.

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Please indicate if you are one of the following groups:
Essential health care worker.  May include licensed health professionals such as physicians, nurse practitioners, physician assistants, registered nurses, LPNs and nurse assistants or laboratory personnel.
Direct support professional.  May include clinicians and support staff serving the behavioral health, intellectual/developmental disabilities and child welfare communities in residential and community- based care settings.
First responder.  May include paramedics, emergency medical technicians, police officers, and firefighters, correctional officers or related support personnel necessary to execute these duties.
Food manufacturing, production, distribution and supply including supermarket workers and food preparation.
Transportation including commercial truck driver of necessary supplies and equipment, transit workers, air and rail and carriers of critical and essential materials.
Construction and Manufacturing including specialized equipment related to health or safety of the public.
Nonprofit and social service agencies providing support to families and employees in related fields.
Please enter the following information:
Name of agency or company you work for (example: ELIH, Greenport Fire Dept, LIRR) *
Job Title *
Parent Contact - First Name *
Parent Contact - Last Name *
Parent Contact - Phone Number *
Parent Contact - Email address
Child Information - How many children would require day care between 8:30am and 2:45pm:
BIRTH TO AGE 2
AGE 3 TO AGE 4
AGE 5 TO AGE 12
AGE 13 TO 18 (special circumstance)
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