Childcare Task Force: Community Interest Form
Share how you or your organization would like to help advance equitable childcare in Hampton.
Thank you for your interest in helping close Hampton's childcare gap. This short form helps us understand how you or your organization would like to get involved, so we can follow up with the right next steps for you.
Name
*
First Name
Last Name
Are you signing up as an individual or on behalf of an organization?
*
Individual
Organization/Business
Organization Name (if applicable)
Email Address
*
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Which best describes you?
*
Parent/Caregiver
Child Care Provider
Educator/Educational Institution
Business/Employer
Nonprofit/Community Organization
Faith-Based Organization
City Staff/Government
Other (please specify)
How would you like to contribute?
*
Reach Out - help spread the word in my networks about this initiative
Share Your Voice - provide feedback, or participate in surveys/focus groups
Offer Space & Resources - share underused space, funding, or in-kind resources
Support Providers - mentor, collaborate, or support new/expanding providers
Participate in Events - host or attend child care fairs, simulations, or planning sessions
Collaborate & Connect - introduce us to potential partners across sectors
Other (please specify)
If you selected “Offer Space & Resources,”, Support Providers", or "Collaborate & Connect" briefly describe what you can offer or your connection/expertise:
What childcare issues or challenges are most important to you? (check all that apply)
Cost of childcare
Finding an open spot or facing long waitlists
Finding care for my child’s age (infant, toddler, preschooler, or school-age child)
Finding care that fits my work or school schedule, including evenings or weekends
Finding before- or after-school care, summer care, or care during school breaks
Finding childcare close to home, work, or school
Getting my child to and from childcare
Finding safe, high-quality care I can trust
Finding care that meets my child’s disability, developmental, or medical needs
Finding backup care when my regular provider is unavailable
Finding clear information about providers and how to enroll
Finding or applying for help paying for childcare
I don’t have any childcare concerns right now
Other (please specify)
Are you able to attend monthly meetings (virtual or in‑person)?
Yes
No
Are you willing to participate in subcommittees or special projects?
Yes
No
Anything else you’d like us to know?
Submit
Should be Empty: