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* Indicates required question
Program Name
*
Your answer
Address
*
Your answer
Zip Code
*
Your answer
Director's Name
*
Your answer
Phone Number
*
Your answer
Director's email address
*
Your answer
My program is...
*
A child care center or group home licensed by DHS
A family child care home certified by DES
Not licensed or certified
My program is...... (Mark all that apply)
*
Nationally Accredited
A Quality First Participant
Neither
Required
Does your program have a contract with DES?
*
Yes
No
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