Provider Updates
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Email *
Are you a licensed:
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Name/Business Name:
Your Name (first and last):
License Number:
Phone Number (If you have two phone numbers please separate with "&" sign):
What is your licensed capacity:
Do you have any openings? (If yes, enter number of opening in the other section.)
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Accepts children (click all that apply):
Open full year?
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Youngest age served:
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Oldest age served:
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Days of operation (check all that apply):
Enter hours of operation (Example 6am to 6pm):
Do you receive Head Start Funding?
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Do you receive Colorado Preschool Program Funding?
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Languages:
Do you provide care for (check all that apply):
Are you?
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Is your home or site (check all that apply)?
Are you on the USDA Food Program (Example: Wildwood Food Program/Southwest Food Program, CACFP)?
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Do you accept the Department of Social Services/Department of Human Services fee assistance (CCCAP)?
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Philosophy (check all that apply):
Philosophy Part 2-If your philosophy is not listed above please explain here.
Serve Special Needs: *
Required
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