Child Care Resource and Referral at John A. Logan College Back to JALC

Licensed Family Child Care Provider Update Form

Personal Information

Program Information

Ages Served From:

Ages Served To:

Additional Staff:

School & Transportation


Schedule

Please check the days that the center is open:






Accepts Children:
Duration:

Rates

I am willing to care for children:




Day Full-Time Enrollment

Evening Full-Time Enrollment

Additional Rate Information






Meals





Total # of Children with Special Needs Enrolled:

Staff has experience working with the following types of special needs:

Environment:




Safety:

Provider Education

I am fluent in:




Additional Program Information