Listing Form - The Child Care Source

Please read and complete all sections of this form.

Listings are a paid advertising option. If you have signed up for advertising with The Child Care Source, please complete the following form. If you would like more information on advertising with The Child Care Source, please click here.

ALL of this information will be published as it is listed here. DO NOT submit duplicate information for the same facility. Please complete a separate form for each facility or section you wish to include in The Child Care Source. If you have questions about this form or need additional information, please call us at 214-ABC-CARE.

* Required Items

*Center/Service Name:

*Contact Name:

*Address:

*City:

*State:

*Zip:

*Phone:

( ) -

*Email:

*Preferred Contact Method:

Display address in listing?

Yes No

Web Address:

License #:

Date Licensed:

Capacity:

Days of Operation:
(Check all that apply)

Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday

Time Open:

Time Closed:

*Levels of Care:
(Check all that apply)

LCC- Licensed Child-Care Cente
LCH - Licensed Child-Care Home
LFH - Listed Family Home
RCH - Registered Child-Care Home
Other

Programs and Services:
(Check all that apply)

INF - Infants
TOD - Toddlers
PRE - Preschool
SA - School Age
PKE - Pre-K Education
SN - Special Needs
SS - Special Skills
ACC - Accredited
FA - Financial Assistance
DI - Drop In Care
PT - Part Time
GW - Get Well Care
AS - After School
TR - Transportation
FT - Field Trip
Other

Please use the space below to write a short description of the center/home and/or the services you wish to advertise.

Description text must be limited to 500 characters. This character count includes each letter, spaces between words and all punctuation marks. Approximately 7 lines of type can be used.

If the text is too long, it will be edited to fit. The complete listing will be typeset and you will receive a proof for your approval before publication.

characters remaining

Notes/Instructions: