Childcare Need

We'd LOVE to support you!

Childcare Need Form

🧸 How the Childcare Form Works

Step 1: Fill Out One Form for Each Child

If you have more than one child, fill out a separate form for each one.
You’ll give us your child’s name, age group, and type of childcare you would like for that child.
Please make sure your phone number is correct! That’s how the program will contact you.

Parent/caregiver first name

Phone number

Parent/caregiver last name

Child's Full Name

Step 2: Pick the Type of Childcare You Want for the appropriate age of your child.

You’ll choose between:
- 🏠 Home-Based Care – A small group of kids in someone’s home (all ages)
- 🏫 Center-Based Care – A bigger group in a daycare center

(Infant, Toddler, Early Pre-K, Pre-K, and Out of School Time)

The form will explain both so you can decide what’s best.

Choose the program that fits your family's needs

based on your child's age group.

Step 3: Get on the Waitlist

After you click SUBMIT, your child's information will be sent to the program of choice as well as others who might have availability and you will be added to the waitlist.

Step 4: Hear from Other Programs

While you wait, other programs that are like the one you picked might contact you by the phone number or email address you provided.

If you don't hear back within 5 business days,

please contact the program of choice or CPC @ 575-956-6667

Step 5: Make Your Choice

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