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Contact CRFHCCA at 319-310-9682

CHILD CARE REFERRALS

Thank you for your interest in obtaining a Child Care Referral. Please note that FHCCA providers are located in the Cedar Rapids metro area (including Marion, Hiawatha, and Robins).

Please complete the following form as completely as possible so our members will have all the information they need on your child care needs. The information you provide on the form will only be accessible to FHCCA members.

If a parent is contacted by a member (or members), the parent has the option to set up an interview or seek alternative arrangements. We hope that we are able to assist you in your search for childcare.

If you do not hear from a member within 5 business days, it means that there is no availability to meet your current child care needs. Please feel free to resubmit your request as needed.

Your information is never shared outside the FHCCA.

Child Care Referral Form

* = Required Fields

*Parent's Full Name(s):

*Contact Phone Number:
   
may be used to verify referral

*E-Mail Address:

*Number of children needing care:

*Ages of children needing care:
 
(e.g., 6 months, 2, 6)

Select the days of the week that child care is needed:
Sun  Mon  Tues  Wedn  Thurs  Fri  Sat 

What are your Time needs?:
Full-Time  Part-Time  Drop-in  Temporary 

*Hours that child care is needed:
 (e.g., 7:00am - 4:30pm)

*Estimated start date:
 (e.g., 1/05/11)

*Which town (side of town) do you prefer?:

Marion NE Cedar Rapids
Hiawatha SE Cedar Rapids
Robins NW Cedar Rapids
No Cedar Rapids Preference SW Cedar Rapids
Mechanicsville Anamosa

*How will you be paying?:
Private (own pocket)

State Block Assistance  State Promise Jobs 
State Protective Care

Unknown/Unsure

Special issues or accommodations:

Other information you would like to share?:

*How did you hear about us?:

NOTE:

The Family Home Child Care Association does not recommend or endorse any child care provider. It is the responsibility of the parent seeking child care to select a provider that best suits their child, their family, and their philosophy on child rearing. You can view the Rules and Regulations for Family Day Care Homes to see what the requirements are.

A home that is registered shows that a provider met the qualifications required by the State of Iowa at the time of the application.

 

 

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