Childcare Referral- Early Childhood Options
Thank you for your interest in Summit County Childcare! This is an application for 2019.
If you would like to contact someone directly with specific questions, you can reach out to Lea Dreux, Office Manager at: lea@earlychildhoodoptions.org (970) 406-3062
Email address *
Names of parent(s) or guardian(s): *
Your answer
Age of caregiver(s) *
Required
How do you want to be contacted? *
Required
What is your physical address?
Your answer
What is your mailing address? *
Your answer
Email? *
Your answer
Phone number? *
Your answer
Do you want your childcare to be closer to home or work?
Your answer
Would you prefer a home-based licensed provider or a childcare center?
Do you have a language preference for your childcare provider? *
Please select your income category: *
What is your employment status? *
If applicable, who is your employer?
Your answer
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