FCCAM Professional Membership Application
FCCAM welcomes all of Maine’s legally operating Family Child Care Providers and their staff to join us in our goal of the achieving the highest standards in Maine’s diverse legal family child care homes promoting the physical, intellectual, emotional, and social development of the children in our care.
Today's Date *
Name (First, Last) *
Your answer
Email *
Your answer
Mailing Address *
Your answer
City/Town/Zip Code *
Your answer
County *
Your answer
Primary Phone Number (include area code) *
Your answer
Years of child care experience or year started in field? *
Your answer
Name of Program *
Your answer
Type of Program *
Do you have employees and if so how many?
Your answer
What age groups do you work with? *
Is your program registered on Maine's Quality Rating System?
If yes, what is your current quality rating?
Please Check All That Apply
If a Military Provider, which branch?
Education Level
What association benefits interest you?
Would you be interested in serving on any of FCCAM's committees?
Social Media Preference
Class A Membership Fee (annual) *
Through the generous support of MRTQ a Basic membership to our national affiliate, National Association for Family Child Care (NAFCC) at this time is only $10. This is for new NAFCC members only. FCCAM will submit all required NAFCC membership paperwork. *
Payment Method *
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