YMCA - Child Care Financial Assistance Support
We are excited to help you navigate your financial assistance options for our YMCA child care programs. Please complete this form and our team will reach out to you with more information.
Sign in to Google to save your progress. Learn more
Email *
Parent First Name *
Parent Last Name *
Email Address *
Phone Number *
Which program(s) will your child(ren) attend? *
This form is intended for families attending YMCA of Rock River Valley Child Care programs. For assistance at Children's Learning Center, please contact the Center Director at 815.977.4576
Required
Which Financial Assistance option are you interested in? *
Required
Do you currently have a Child Care Assistance approval from IDHS? (YWCA) *
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of YMCA of Rock River Valley.

Does this form look suspicious? Report

Google Forms