Community-Minded ECEAP Subcontractor Inquiry Form
Thank you for your interest in becoming an ECEAP subcontractor with Community-Minded Enterprises. We are excited to explore this opportunity with you. Please fill out the form below to express your interest in being awarded ECEAP slots. Your information will help us understand your qualifications and how we can best support you in this process.
Your Name
*
First Name
Last Name
Your Title
*
Name of your Child Care Program:
*
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email:
*
example@example.com
Address of Child Care Program
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Website (If applicable):
*
Type of Child Care Program:
*
Licensed Center-Based
Licensed Family Home Childcare
Enrollment capacity:
*
Ages Served:
*
Infants (0-12 months)
Toddlers (1-3 years)
Preschool (3-5 years)
School Age (5+ years)
Does your program participate in any other subsidy programs? (e.g., Head Start, State Childcare Assistance, etc.)
*
Yes
No
Please Speciffy:
*
Submit
Should be Empty: