Childcare Interest form
Please fill out the information below. Once you submit it, we will reach out to you as soon as we can.
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Which program were you interested in? *
Required
Parent/Legal Guardian's name *
Phone number *
Name & Date of Birth of the Child(ren) *
Any allergies? *
Links for the applications to apply for the tuition assistance program Childcare Services (CCS), 


and for the  Early Head Start (EHS) program. 

Any questions?
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