Institutional & Organizational Childcare Request Form

Institutional & Organizational Childcare Request Form

Night Owl Kids Care, LLC.
Contracted & Ongoing Care

This form is for institutions and organizations seeking recurring or contract-based childcare services. One-time events should use our Event Care Request Form Here.
Organization Information
Organization/Institution Name*
Organization Type*

College/UniversityPrivate or Boarding SchoolCorporate EmployerNonprofit/AssociationGovernment-Adjacent OrganizationOther
Website (Optional)
Primary Contact Information
Contact Name*

First NameLast Name
Title/Role*
Email*
example@example.com
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Program Overview
Type of Care Requested*

Ongoing Weekly ProgramDaily ProgramSeasonal or Academic-Calendar ProgramPilot/Trial ProgramOther
When do you want care to start?*

Immediately/As soon as possibleIn 1 monthWithin 3 monthsOther
Location for Childcare*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Please select what best describes your space for childcare*

We have an already established and dedicated childcare building or centerWe have an already established and dedicated childcare room(s)We have a room that can be a dedicated childcare space and will need assistance setting upWe have a multi-purpose room that can be used for childcare, but will need to be restored after each service for others to useOpen to guidance from Night Owl Kids CareOther
Please provide more information on your space (please list room numbers, and description of what we can access for care)
Which best describes your knowledge of your childcare needs?*

I have general information that includes estimatesI have specific days and times we need careI have specific dates and times but the time frames vary for each date
General Childcare Needs*
Specific Childcare Needs (Dates with Varying Times)*
Estimated Program Start Date

MonthDayYear
Date
Specific Childcare Needs (Days and Set Times)*
Age Ranges Accepted (Select all that apply)*

Infants 6 weeks- 6 months (special request, greatly impacts ratios 1:2)Infants 6months-12 monthsToddlers 12 months- 36 monthsPreschool 3 years and 4 yearsSchool-Age (5 years through 12 years)Teens (13 yrs + Special Request)
Any anticipated needs for one-on-one care or accommodations?*

YesNoPossibly, please provide options for us to consider
Program Structure Preferences
Preferred Care Style

Structured programmingSupervised free playQuiet care/ study supportCombination
Will this program support:*

EmployeesStudentsFaculty/StaffMembersFoster FamiliesEvent or program participantsOther
Compliance & Institutional Considerations
Does your organization require:*

Proof of licensing & insuranceSpecific Background ChecksStaff orientation or site onboardingNDA or confidentiality agreementsVendor registration/ procurement reviewNA
Budget & Approval Process (Optional but Helpful)
Estimated Budget Range (if known)
Approval or Procurement Timeline
Is this a budgeted program?

YesIn PlanningExploring Options
Please share any additional details that you believe will help us evaluate your request:
Acknowledgement*

I understand this request is for contracted or ongoing childcare services and that pricing and staffing options will be provided after review.
Should be Empty:

Institutional & Organizational Childcare Request Form

Organization Information

Primary Contact Information

Program Overview

Program Structure Preferences

Compliance & Institutional Considerations

Budget & Approval Process (Optional but Helpful)