Scott County Licensed Family Child Care Association's Provider of the Year Nomination Form
Please fill out this form and submit on behalf of the provider you wish to nominate. "Provider of the Year" recipients must meet the following requirements: 1) Be licensed for a minimum of 3 years 2) Have not previously received this award within the past 10 years 3) Must be in good standing with licensing.
Child Care Provider's Name
Your answer
Nominee's Address
Your answer
City, State, Zipcode
Your answer
Telephone Number ( ) -
Your answer
What is your relationship with this provider?
Submitted by
Your answer
Please share your provider's strengths and contributions to the family child care profession.
Your answer
Other Services Offered: (check all that apply)
Thank you for submitting this application. Two providers will be chosen from Scott County and honored through the local association. All nominated providers will be recognized by SCLFCCA. Nominations are accepted year round. Nominations submitted after December 31st are eligible for the selection process the next calendar year. Questions? contact Kara at scottcountyprovideroftheyear@gmail.com
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