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Updated Guidance Regarding H1N1
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CCN Family Child Care Update Form
Provider First Name
Provider Last Name
Email
Family Child Care Providers
Full Time Vacancies
Days & Hours Open
Full Time Rates
Part Time Rates
Infant (1-14 months)
Toddler (15-13 months)
Preschool (2.9-5 years)
Before/After Kindergarten (5-6 years)
School Age (6-12 years)
EEC License Number
License Capacity
License Expiration Date
CDA
NAFCC
Approved Assistant Name
Certificate Number
Expiration Date
Total Vacancies
Are there any changes in your program you would like us to know about?
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