Essential Employee COVID-19 Childcare form
If you are an essential employee who would not be able to stay at home to care for children in case of a COVID related school closure, please fill out this form. We are trying to organise childcare options for you.
Sign in to Google to save your progress. Learn more
What is your industry?
Clear selection
What is your job title
How many children do you have?
Clear selection
What is the age of your OLDEST child?
Clear selection
What is the age of your YOUNGEST child?
Clear selection
How many hours of childcare do you need per week?
Do you have a partner or other adult living with you who can care for your children? If so, how many hours can they provide a week?
What days of the week do you work?
What are your typical work hours?
Where do your children attend school? Include postcode.
If your children also attend wrap around care, please tell us the provider.
Is there anything else you think we should know?
How should we get in touch with you?
Clear selection
What is your name
Please provide your contact information if you would like assistance:
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report

Google Forms