ELSSA Membership Application
Please add your details below, and we will contact you to finalize the application process. Thank you!
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Your Full Name *
Your Program's Name *
Program's Legal Name (if different)
Email Address *
Program Address *
County *
Is your program a Family Child Care Home or Child Care Center? *
How long have you operated your program? *
What is your race? *
Are you of Hispanic or Latino origin? *
What is your preferred spoken/written language? *
What is your business structure? *
Date of your last CLASS assessment: *
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DD
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Aggregate CLASS Score *
What is your current program enrollment? *
What is your ideal program enrollment? *
Do you currently use Child Care Management Software (like Procare, KidKare, Brightwheel)? *
Do you have access to any of the following pieces of technology? *
Required
Internet Access: *
How is your experience with your Internet Service Provider? *
Which ELSSA services are of interest to you?
Thank you for your interest! We will be in touch shortly to finalize the application process.
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