Provider Listing Request Form

Our Child Care Resource & Referral team is available Monday through Thursday from 8am to 5:30pm and on Fridays from 8am to 12pm. This team will be able to assist you by providing valuable information to meet all your Resource & Referral needs; including but not limited to child care and financial assistance programs, health care programs, child welfare and abuse information, services for children with special needs and/or developmental disabilities, guidance as to the listing's contents, up to date information on the availability of resources, as well as linkages to other community resources that may be available. Listings are e-mailed to you; please allow 3 business days for your request to be processed.

 

APPLICANT INFORMATION
*Please be sure to check your spam/junk folder within 3 business days to ensure your receipt of an e-mail containing the requested information.
*Would you like a call in regards to other community resources?:
CHILD INFORMATION
mm/dd/yyyy
mm/dd/yyyy
mm/dd/yyyy
mm/dd/yyyy
TYPE OF CHILD CARE
*What type of child care are you interested in? (Check all that apply):
REASON FOR CARE
*What is the reason child care is needed? (Check all that apply):
CHILD CARE ISSUES
*What issues are you experiencing in securing child care? (Check all that apply):
SCHEDULE NEEDED
*Days Needed:
*Transportation:
*Special Needs:
*Other Schedule Needs:

Contact Us

Parents: (561) 514-3300

Providers/Administrative: (561) 214-8000
Send us an email


Accessibility Statement

Special Notice: If you require Americans with Disabilities Act accommodations to participate in any ELCPBC event or activity, please notify Christie Young, Single Point of Contact, by phone at 561-214-7424 or by email at christie.young@elcpalmbeach.org within at least seven (7) days of the event.  Accommodations will be provided at no extra charge.