REGISTRATION INFORMATION PAGE
Name & Address of your Child Care Facility
IMPORTANT! Please enter the unique name, actual physical address and zip code of the child care facility for which you are registering. DO NOT use headquarter/main office names or addresses. Registrations that appear to be duplicates based on name/address/zip code combinations may be deleted.
* Required Fields
Primary Contact Information
Owner
Director
Assistant Director
Lead Teacher
Other (please specify)
About Your Child Care Program
Child Care Center
Family Child Care Home
Preschool
Yes
No
Full-day
Half-day
Both full- and half day
Enter the number of children by age enrolled in your program.
0-23 months
24-35 months
3-5 years
School age children (either in before and/or after school program or summer program)
Don't know
Yes Go to 5a.
If participating in CACFP, then do you participate:
Through a sponsoring agency (e.g. Family Service, Provider’s Network, Midwest Child Care Association, Child Nutrition Services, Panhandle Family Daycare, etc.)
Through a state sponsorship (e.g. Nebraska Department of Education/Nutrition Services)
Other (please specify) -
Not applicable
None
Less than 50%
50 to 59%
60 to 69%
70 to 79%
80 to 89%
90 to 99%
100%
Money from Head Start program budget
Money from fundraising events
Money or food from a school or school district
Money or food from faith-based organizations
Money or food from local businesses
Food from food pantries or food banks
Food from parents
Cooks who are hired directly by our program
The food service program of a school, school district or school food authority
A food service company
I am a family child care home provider and I cook the meals for my child care.
Meal
Not provided
Usually provided by childcare setting
Usually brought from home by parents
a. Breakfast
b. Lunch
c. Dinner
d. Mid-morning snack
e. Mid-afternoon snack
f. Evening snack
Don't Know/Not Sure