Childcare Survey

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Childcare Survey

Safari Daycare is hoping to begin an after school care program for children ages 4 and up in the near future at CCE. Please indicate your needs by responding to the survey questions below for 2nd semester of the 21-22 school year.

Sign in to Google to save your progress. Learn more

* Indicates required question

Childcare

How many children are you looking to enrolll *

Choose

1

2

3

4

5

6

7 or more

Please list the ages of the children that would attend day care. *

Your answer

How many days of the week are you seeking care? *

Choose

1

2

3

4

5

Do you need Part-time or Full-time care *

Part-Time

Full-Time

Required

Next

Clear form

Never submit passwords through Google Forms.

This form was created inside of Clay Central Everly Community School District. Report Abuse